Heterotopic Pregnancy: A Rare Cause of Acute Abdomen

Background:Coexistence of an intrauterine pregnancy and an ectopic pregnancy is termed aheterotopicpregnancy. The ectopic pregnancy can be tubal, cornual, cervical, ovarian, or abdominal. The incidence of heterotopic pregnancy with natural conception is similar to 1:30000. This article reports on a patient with a heterotopic pregnancy after spontaneous conception, which is very rare. Case:A 25-year-old primigravida at 11 weeks of pregnancy presented with an acute abdomen along with vomiting and vaginal bleeding. An examination revealed that she had a tense and tender abdomen. Her uterus was equivalent to 14 weeks' pregnancy. On vaginal examination, tenderness and fullness was present in the left side of her pelvis. A transvaginal ultrasound finding was suggestive of a ruptured left-sided tubal pregnancy with a live intrauterine fetus. The patient underwent emergency laparotomy followed by a left salpingectomy. Results:This patient's postoperative period was uneventful. Conclusions:Early clinical diagnosis should be performed, and a high index of suspicion for heterotopic pregnancy should be maintained in any pregnant woman presenting with an acute abdomen.