An unusual presentation of ectopic pregnancy

Abdominal pregnancy is a rare form of ectopic gestation. When it occurs, its early diagnosis is difficult, owing to the atypical presentation and the low index of suspicion for the condition. The characteristic history is that of abdominal pain, vaginal bleeding and symptoms related to the gastrointestinal tract. These symptoms are occasionally overlooked and the diagnosis is often missed. The following report describes a case of a 12-week abdominal pregnancy presenting as an acute abdomen placental attachment to the anterior abdominal wall muscle. Transabdominal ultrasound was successfully used to make the diagnosis preoperatively. Surgical intervention resulted in removal of the complete sac together with the placental disc in toto. The important features of this rare but morbid condition are discussed, and the important role of sonographic imaging in cases of acute abdomen in pregnancy is stressed.