Is ectopic pregnancy possible after hysterectomy?

OBJECTIVE

To determine whether ectopic pregnancy should be suspected in young women with abdominal pain even after hysterectomy.

DESIGN

Case report.

SETTING

The patient presenting with abdominal pain in the emergency department was referred to a tertiary care center.

PATIENT(S): A young woman who had had a subtotal hysterectomy 3 years prior for atonic postpartum hemorrhage during her last caesarean section presented with acute abdominal pain.

INTERVENTION(S): Urgent ultrasound showed a gestational sac of 9 weeks + 3 days. Emergency laparotomy was done for suspected ectopic pregnancy.

MAIN OUTCOME MEASURE(S): Ultrasound, operative findings, and histopathology.

RESULT(S): Tubal ectopic pregnancy was confirmed on laparotomy and histopathology.

CONCLUSION(S): Early suspicion can avoid missing early and treatable ectopic gestation before life-threatening complications develop.