Ectopic pregnancy implanted under the diaphragm: A rare case report

Abstract

BACKGROUND Abdominal pregnancy is a rare type of ectopic pregnancy. We describe here a case of ectopic pregnancy implanted under the surface of the diaphragm, presentingthe particular features of imaging findings from ultrasound, computedtomography (CT) and magnetic resonance imaging (MRI).CASE SUMMARYA 30-year-old woman presented with complaint of intermittent abdominal pain,that had begun 5 d earlier. She had no current or abnormal vaginal bleeding, andher serum human chorionic gonadotropin level (13372.08 IU/L) indicatedpregnancy. Vaginal ultrasound showed a mixed echogenic mass in the rightovary. CT (plain) scan showed a curved high density mass beneath the subhepaticspace. MRI scan showed a curved mixed signal, with restricted diffusion beneaththe subhepatic space. Abdominal ultrasound demonstrated a mixed echogenicmass in the right lobe of the liver near the apex of the diaphragm, with a visibleyolk sac and germ cell region with a bud. Subsequent laparoscopy visualized adark red mass under the right diaphragm, which was resected completely.Histopathological examination of the resected mass confirmed an ectopicpregnancy. The recovery was swift and uneventful, and the patient wasdischarged to home.CONCLUSIONEctopic pregnancy should be in the differential diagnostic workup (via multipleimaging modalities) of childbearing woman with unexplained abdominal pain