Abstract
Posthysterectomy ectopic pregnancy is an unusual condition that may present soon after hysterectomy or several years later. Similarly, although tubal ligation is a widespread method of contraception, tubal pregnancy after tubal ligation is not common either. If any of these conditions are rare, having an ectopic pregnancy after hysterectomy and tubal ligation is even more infrequent and only one of such cases was found in our review of the literature. We describe the case of a 35-year-old patient, with history of bilateral tubal ligation and vaginal hysterectomy that looked for medical attention due to abdominal pain. A pregnancy test was positive and a transvaginal ultrasound demonstrated the presence of a gestational sac at the vaginal cuff, adjacent to the ovary. An exploratory laparotomy showed a ruptured ectopic pregnancy located in the distal portion of the left fallopian tube. The occurrence of an ectopic pregnancy several years following tubal ligation and vaginal hysterectomy is a rare phenomenon that appears to be secondary to a fistulous connection into the peritoneal cavity.
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Lawson HW, Atrash HK, Saftlas AF, Franks AL, Finch EL, Hughes JM (1988) Ectopic pregnancy surveillance, United States, 1970–1985. MMWR CDC Surveill Summ 37(5):9–18
Goldner TE, Lawson HW, Xia Z, Atrash HK (1993) Surveillance for ectopic pregnancy, United States, 1970–1989. MMWR CDC Surveill Summ 42(6):73–85
Stovall TG (2002) Early pregnancy loss and ectopic preganacy. In: Berek JS (ed) Novak’s gynecology. LWW, Philadelphia, p 511
Isaacs JD Jr, Cesare CD Sr, Cowan BD (1996) Ectopic pregnancy following hysterectomy: an update for the 1990s. Obstet Gynecol 88(4 Pt 2):732
Beuthe D, Wemken K (1985) Tubal pregnancy after a previous tubal ligation and hysterectomy. Geburtshilfe Frauenheilkd 45(3):188
Binder DS (2003) Thirteen-week abdominal pregnancy after hysterectomy. J Emerg Med 25(2):159–161
Sims HS, Letts HW (1974) Delayed ectopic pregnancy following vaginal hysterectomy. Can Med Assoc J 111(8):812
Sheth SS (2005) Vaginal hysterectomy. Best Pract Res Clin Obstet Gynaecol 19(3):307–332
Peterson HB, Xia Z, Hughes JM, Wilcox LS, Tylor LR, Trussell J (1997) The risk of ectopic pregnancy after tubal sterilization. U.S. Collaborative Review of Sterilization Working Group. N Engl J Med 336(11):762–767
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Rosa, M., Mohammadi, A. & Monteiro, C. Ectopic tubal pregnancy after hysterectomy and tubal ligation. Arch Gynecol Obstet 279, 83–85 (2009). https://doi.org/10.1007/s00404-008-0645-0
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DOI: https://doi.org/10.1007/s00404-008-0645-0