Primary omental ectopic pregnancy

Abstract

Omental ectopic pregnancy is a rare form of ectopic pregnancy. Presented here is a case primary omental ectopic pregnancy according to Studdiford's criteria. This patient presented with epigastric pain and anemia without vaginal bleeding, lower abdominal or pelvic pain. Pregnancy status was confirmed after admission. Transvaginal ultrasound examination revealed intrauterine contraceptive device in situ and a large amount of free peritoneal fluid, but no intrauterine sac or adnexal mass. Laparoscopy was performed but pelvic pathology did not account for the 2500 mL of haemoperitoneum. Laparotomy was carried out and partial omentectomy was performed.

Early Abdominal Ectopic Pregnancies: A Systematic Review of the Literature

“…Omental ectopic pregnancies were more frequently treated by laparoscopy than abdominal ectopic pregnancies at all other locations. Of the 25 cases, 9 women [93,98,100,102,109,111,113,114,115] received a blood transfusion (36%) with an average blood loss of all cases of 1,160 ml (range minimal to 3,000 ml). All 25 patients presented with abdominal pain with 3 of the patients having pain in the epigastrium [94,111,113].…”

“…Of the 25 cases, 9 women [93,98,100,102,109,111,113,114,115] received a blood transfusion (36%) with an average blood loss of all cases of 1,160 ml (range minimal to 3,000 ml). All 25 patients presented with abdominal pain with 3 of the patients having pain in the epigastrium [94,111,113]. Additionally, 7 patients complained of nausea and/or vomiting [94,95,96,100,109,113,114].…”

“…All 25 patients presented with abdominal pain with 3 of the patients having pain in the epigastrium [94,111,113]. Additionally, 7 patients complained of nausea and/or vomiting [94,95,96,100,109,113,114]. …”

“…There were 25 reports from 24 different references of an abdominal pregnancy being primarily implanted on the omentum [42,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115]. The patient’s average age at initial presentation was 27 (range 13–36) with the average gestational age at diagnosis of 7 weeks and 2 days (range 4–16 weeks) and parity of 1.3.…”

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“…Laparotomy was performed in most of the reported cases [8,9] because of late presentation, severe haemorrhage encountered during laparoscopic surgery or lack of immediate expertise. Laparoscopic surgery for omental pregnancies had been reported especially in early presentation when the sac is not yet ruptured [10,11].…”