Coexistence of Unruptured Twin Tubal Ectopic Pregnancy with Tubo-Ovarian Abscess in the Same Adnexa: a Case Report and Literature Review

Abstract

Ectopic pregnancy is the implantation of a gestational sac outside of uterine cavity. Majority of cases occur in the fallopian tubes. It has remained the leading cause of first trimester cause of maternal mortality. Incidence has increased with increase in sexually transmitted diseases and assisted conception and improved earlier diagnosis while mortality has reduced due to improved earlier diagnosis with more conservative and less invasive treatment modalities. Tubo-ovarian abscess (TOA), an ascending polymicrobial infection of the upper genital tract in females usually presents with symptoms such as lower abdominal pain, bleeding from the vagina and fever, which sometimes presents a diagnostic dilemma between TOA and ectopic pregnancy. Both disease conditions are potentially life threatening. We present a case of a 33-year-old woman with co-existing TOA and unruptured ectopic pregnancy.