Left tubal ectopic gestation coexisting with right pyosalpinx: A case report

Abstract

Ectopic pregnancy is one of the commonest gynaecological emergencies in the developing world and represents a significant proportion of maternal mortality. A common aetiologic factor is Pelvic Inflammatory disease, which leads to tubal damage that can predispose to ectopic pregnancy. Both conditions tend to be differential diagnosis of each other. However, they are rarely believed to co-exist The clinical case is of a 33-year-old nulliparous woman who presented with lower abdominal pain and vaginal bleeding following 8 weeks of amenorrhoea. She had previously attempted a surgical termination of the pregnancy and ultrasound scan showed a left adnexal mass. She had an exploratory laparotomy with findings of a left tubal ectopic and right pyosalpinx.
Although, pelvic inflammatory disease is generally believed not to co-exist with pregnancy, in uncommon circumstances such as these, it can occur. Dilemmas exist, particularly as to management decisions regarding surgical options for both the tube with the implantation and that with the infective inflammation. Clinicians need to be aware that coexistence is possible and management strategies perhaps need to be discussed to maximize potential fertility preservation.

Key words: Ectopic Pregnancy, Pelvic Inflammatory disease, Pyosalpinx