MRI findings in ruptured ovarian ectopic pregnancy: an unexplored avenue

Authors

  • Annu Singhal Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India http://orcid.org/0000-0003-0911-1279
  • Vivek C. Kottiyath Department of Radiodiagnosis, Sky Dianostics, Uttam Nagar, Delhi, India
  • Tej Prakash Gupta Department of Radiodiagnosis, Saral Diagnostics, Saraswati Vihar, Delhi, India
  • Prachi Arora Department of Gynaecology and Obstetrics, Bhagwan Mahavir Hospital, Rani Bagh, Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20214354

Keywords:

OEP, EP, TVS, Magnetic resonance imaging, Gestation sac, POD, Beta-human chorionic gonadotropin

Abstract

Ovarian ectopic pregnancy (OEP) is a rare form of ectopic pregnancy (EP) and constitutes approximately 0.5-3% of all ectopic cases. Its presentation mimics the symptoms of tubal ectopic pregnancy, hemorrhagic ovarian cyst/follicle, tubo-ovarian abscess, urinary tract calculi, appendicitis or ovarian torsion. Occasionally determining the anatomic location of an extra-tubal ectopic pregnancy based on ultrasound imaging and presentation alone can be challenging, particularly when it is adherent to the fallopian tube. Although transvaginal ultrasound (TVS) is the primary modality used in the diagnosis, various forms of OEP and its complications may be incidentally detected and further evaluated on computed tomography (CT) or magnetic resonance imaging (MRI) when an alternative diagnosis is suspected. We reported a case of a second gravid para zero, 25 years old lady, who came with pain in the left lower abdomen. Her urine pregnancy test was positive. TVS showed empty uterine cavity, an extremely tender, heterogenous hyperechoic right adnexal mass, but no obvious gestation sac (GS). A large hematoma was detected adjacent to it in the pouch of Douglas (POD). Keeping a high suspicion of ectopic pregnancy, MRI was performed to evaluate the lesion better which revealed a natural, non-assisted, ruptured right ovarian ectopic pregnancy and was subsequently confirmed at laparotomy and proven on histopathology. Patient underwent left oophorectomy and discharged on 4th day with uneventful follow up.

 

Author Biography

Annu Singhal, Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India

Department of Radiodiagnosis, Associate Professor

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Published

2021-10-27

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Section

Case Reports