Misdiagnosis of spontaneous bilateral tubal pregnancy: a case report and review of literature

Purpose of Investigation: Spontaneous bilateral tubal ectopic pregnancy (BTP) is the rarest form of ectopic pregnancy. Materials and Methods: A case of BTP diagnosed during surgery is reported and an algorithm has been proposed for the management of such patients. It is a case of a 32-year-old female at gestational age of nine weeks with spontaneous pregnancy reported vaginal bleeding. Results: The case describes the importance of identifying and examining both tubes at laparoscopy, despite the rarity of bilateral extra-uterine pregnancy. Emergency exploratory laparotomy revealed ruptured ectopic pregnancy along with active bleeding of the right tube (fimbrial region). The left tube was distended with a 3x4-cm mass at the fimbrial region. Conclusion: Bilateral conservative surgery is possible with unruptured ectopic tubal pregnancy.