Background:

Abdominal ectopic pregnancy is a rare condition in obstetrics, especially if there is a history of hysterectomy. Symptoms are usually nonspecific and the diagnosis is often delayed by low clinical suspicion, with consequent increase in maternal morbi-mortality.

Clinical case:

33 year-old patient with 3 previous cesareans and subtotal hysterectomy postpartum for placenta accreta, referred by abdominal pain and vaginal bleeding. In the gynecological ultrasound, a gestational sac was visualized with an embryo according to 12 + 4 weeks, with positive heartbeat. Urgent laparotomy was indicated for acute abdomen and suspicion of abdominal ectopic pregnancy, showing a gestational sac of 7 centimeters adhered to sigma and cervical stump with a bleeding broken zone to abdominal cavity that enclosed left annex, reason why resection of ectopic gestation and left annexectomy was performed in collaboration with General Surgery Service. The postoperative period was without consequences and the patient was satisfactorily discharged.

Conclusions:

It is important to include this entity within the differential diagnosis of acute abdomen women of childbearing age, even if a previous hysterectomy has been performed.