Ruptured heterotopic interstitial pregnancy: rare case of acute abdomen in a Jehovah's Witness patient

Objective: To report a case of ruptured right heterotopic interstitial pregnancy diagnosed and managed laparoscopically by cornual resection. Design: Case report. Setting: University tertiary care hospital. Patient(s): A 29-year-old female Jehovah's Witness patient with first-trimester acute right lower quadrant abdominal pain. Intervention(s): Emergency laparoscopy was performed, and the site of bleeding was first clamped with a laparoscopic grasper. The lateral tissue was then coagulated and simultaneously transected with the bipolar-cutting probe for control of hemorrhage. Main Outcome Measure(s): The early diagnosis of heterotopic interstitial pregnancy should enable a conservative approach, whether medical or surgical, to be undertaken when treating this rare and potentially fatal condition. Result(s): The treatment of a ruptured heterotopic interstitial pregnancy by laparoscopy was successful with cornual resection. Conclusion(s): Management of a ruptured interstitial pregnancy by laparoscopy was successful with cornual resection and minimal blood loss, and a coexiting intrauterine pregnancy continued satisfactorily. (Fertil Steril (R) 2008; 90: 1200.e15-e17. (C) 2008 by American Society for Reproductive Medicine.)