February 22nd, 2019

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Primary Omental Pregnancy After Unilateral Salpingectomy: A Case Report
Authors:  Dong-wook Kim, M.D., Woo Gyeong Kim, M.D., and Gyun-Ho Jeon, M.D.
BACKGROUND: Omental pregnancy is one of the rarest forms of ectopic pregnancy. About 41 cases of omental ectopic pregnancy have been reported so far in the literature, but only 24 of those are considered primary omental pregnancies according to a Medline database search.

CASE: We present a case of primary omental pregnancy in a 41-year-old, gravida 4, para 0 woman who presented with clinical features of ruptured ectopic pregnancy and massive hemoperitoneum. Both adnexa showed no sign of pregnancy during surgical exploration, but there was a bleeding focus that originated from the right side of the omentum in the lower abdomen. Histopathologically, extensive chorionic villi formation with dense trophoblastic invasion of omental tissue in the background of the hemorrhage was revealed as primary omental pregnancy. Serum hCG level was normalized at 6 weeks postoperatively.

CONCLUSION: Although rarely seen, primary omental pregnancy can present clinically similar to ruptured tubal pregnancy. Therefore, thorough examination of the omentum should be emphasized as an unusual implantation site when tubes and ovaries show no sign of pregnancy during surgical exploration for suspected ectopic pregnancy.
Keywords:  abdominal pregnancy, ectopic pregnancy, laparotomy, omental pregnancy, omentum
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