Ruptured isthmic tubal ectopic pregnancy

36 yr old G3 P2 at 6 weeks presented with abdinal pain Chief Complaints History of amenorrhea for one and half months. Lower abdominal pain since one day. History Pt had previous 2 normal vaginal deliveries. This time she had amenorrhea and abdominal pain . No bleeding pv Vitals Pulse was 106 / min. BP was 110/70 mmHg. Physical Examination Per abdomen- tenderness present in suprapubic region. No guarding or rigidity. PV done uterus normal size, Anteverted , right side forniceal bogginess felt. CET positive Investigations Hb- 8 gm%. Ultrasound revealed right adnexal mass 3*3 cm and hemoperitoneum 3 +. Diagnosis Pt was taken up for laparotomy . OT findings- right sided ruptured isthmic tubal ectopic pregnancy with actuve bleeding and hemoperitoneum of 500 ml Management Right sided salpingectomy with left sided tubal ligation done( consent taken).

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Exuterine gestations are known Tubal pregnancies are exception to mature Here it was an emergency ruptured tubal pregnancy with bleed Laprotomy and salvage of findings done Well done sir life could be saved

Thank you doctor
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Very helpful case doctor.. thank u... Let me know one thing... Many times patients manage to take MTP kits in black (illegal) If conceived.. they don't want to undergo USG as well. In case if in such case, 2 month amenorrhea, and if she has taken MTP {mefi +meso} , and if its proved to be an ectopic pregnancy, then what may happen? Now a days these things happening in practice..

Such patients come with either tubal rupture in shock at a later date....or tubal abortion
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Extra uterine pregnancy.. When an ectopic pregnancy ruptures, bleeding may be severe and even threaten the life of the woman... Well managed Dr.Virajji.

Well done. Congratulations to all team members and thanks for sharing.

Thank you doctor
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RUPTURED ISTHMIC TUBAL ECTOPIC. PREGNANCY... .. NICELY.... WELL. MANAGED SIR THANKS. FOR. THE. USEFUL. UPDATE

Appreciating surgery Good surgeon

Thank you doctor
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Good case Sir instead of open laprotomy is Laproscopic salpigectomy is option? What should be the cause of ectopic in the case?

In case of ruptured ectopic with pulse being high plus Hb of 8.4gm% and hemoperitoneum ..laparotomy is adviced.. Cause of ectopic appears to be 1. PID 2. Long length of the fallopian tube
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Ectopic tubal pregnancy, well management in time.

Dx Ectopic Tubal Pregnancy ??? Nice management of Case.

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