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Case Reports
. 2015 Jan 12:8:1-4.
doi: 10.4137/CCRep.S20907. eCollection 2015.

A case of successful laparoscopic surgery for tubal stump pregnancy after tubectomy

Masakazu Nishida  1 , Yuko Miyamoto  1 , Yasushi Kawano  1 , Kanetoshi Takebayashi  1 , Hisashi Narahara  1
Affiliations
Case Reports

A case of successful laparoscopic surgery for tubal stump pregnancy after tubectomy

Masakazu Nishida et al. Clin Med Insights Case Rep. .

Abstract

The incidence of ectopic pregnancy is approximately 1.3-2% of all pregnancies, and more than 90% of ectopic pregnancies are detected in the ampulla of the fallopian tube. Ectopic pregnancy occurring in tubal stump after tubectomy is extremely rare, and the frequency of tubal stump pregnancy is approximately 0.4% of all pregnancies. We report one of these rare cases of ectopic pregnancy in a 26-year-old Japanese woman, gravida 4, parity 1. She had undergone laparoscopic tubectomy because of a tubal pregnancy two years ago. She was presented to our hospital with a positive pregnancy test, but no gestational sac was detected in the uterus by echography, even though the level of human chorionic gonadotropin (hCG) in the blood was elevated to 8,900 mIU/mL. Laparoscopic surgery for ectopic pregnancy was performed. During surgery, the position of the pregnancy was found to be in the tubal stump, where tubectomy had already been performed, and the gestational sac was successfully removed. After the surgery, the condition of the patient uneventfully improved and she was discharged from the hospital three days after the surgery. The diagnosis of tubal stump pregnancy is more difficult than that of the more common positions of an ectopic pregnancy in the fallopian tube, and so it is more important to carefully examine the patients with suspected ectopic pregnancy. Laparoscopic surgery is one of the options for tubal stump pregnancy if diagnosed early and if the condition of the patient is stable.

Keywords: Laparoscopic surgery; ectopy; tubal stump pregnancy.

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Figures

Figure 1
Figure 1
The lesion of tubal stump pregnancy appears in the fallopian tube at the left side of uterus.
Figure 2
Figure 2
The laparoscopic finding of the ectopic part at the right tubal stump of the uterus.
Figure 3
Figure 3
The wound after resection of the ectopic part is sutured with VICRYL, with only a small amount of bleeding.
Figure 4
Figure 4
Nonvisibility of the chorionic villi macroscopically in the removed lesion.
Figure 5
Figure 5
The chorionic villi detected microscopically in the removed ectopic part. (A) Hematoxylin and eosin staining (H&E), ×100. (B) H&E × 400.
See this image and copyright information in PMC

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