Ruptured primary ovarian ectopic pregnancy presenting as acute abdomen: A rare case report

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Primary ovarian ectopic pregnancy is a rare and potentially life-threatening form of extrauterine gestation, accounting for less than 3% of all ectopic pregnancies. Preoperative diagnosis is difficult because clinical and radiological findings often mimic tubal ectopic pregnancy or hemorrhagic ovarian cyst. We report a case of a 24-year-old multiparous woman who presented with acute abdomen, syncope, and hemodynamic instability. Serum beta-human chorionic gonadotropin was 5030 mIU/mL. Ultrasonography revealed a large left adnexal hematoma with significant intraperitoneal fluid. Emergency laparotomy confirmed a ruptured primary ovarian ectopic pregnancy with massive hemoperitoneum. Surgical intervention along with blood transfusion resulted in a favorable outcome. This case highlights the diagnostic challenges and the importance of early surgical management in preventing maternal morbidity.

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