BACKGROUND:

Abdominal pregnancy has an estimated incidence of 1 case per 10,000 births and corresponds to 1.4% of all ectopic pregnancies. Whether they result from secondary implantation of an aborted tubal pregnancy or from intra-abdominal fertilization has not been determined to date.

CLINICAL CASE:

A 36-year-old female patient came to the emergency room due to transvaginal bleeding accompanied by abdominal pain located in the hypogastrium. She had been amenorrheic for 8 weeks. Vital signs: blood pressure 100-60 mmHg, heart rate 83 bpm, respiratory rate 21 rpm and temperature 36.5 oC. Immunological pregnancy test was reported positive. On pelvic ultrasound the uterus lacked intrauterine gestation. The right adnexal lesion was complex and oval. Since there was free fluid in the cavity, an exploratory laparotomy was performed; a gestational sac was found implanted in the omentum, bleeding. Partial surgical excision of the affected omentum was decided, and the procedure was successful. The trans-operative course was uneventful, and the patient was discharged from the hospital after 48 hours, without complications.

CONCLUSION:

Abdominal pregnancy is rare, early diagnosis and treatment make a difference in the maternal mortality rate. Clinical correlation and risk factors supported by diagnostic aids further facilitate its suspicion.