Abstract Abdominal pregnancy (AP) is rare with an estimated incidence of 1/10000 births and only 1.4% of ectopic pregnancies. Primary abdominal pregnancy (PAP) is the least common form of the AP. We present a case of PAP in a 22 year-old woman who was admitted in our department with diffuse abdominal pain, predominant in the pelvic area with a good general condition. The serum βhCG level was 1643 mIU/mL. Ultrasonographic exploration showed an empty uterus with a free fluid and hyperechoic mass in the Douglas pouch. An emergency laparoscopic surgery showed abdominal pregnancy located on the sigmoid colon. Resection of the PAP and hemostasis were performed by laparoscopy. To our knowledge, only four cases of PAP implanted on the sigmoid colon have been reported to date but only two have been treated by laparoscopy. AP must be diagnosed and treated early to avoid complications such as hemorrhage due to placental implantation that is a potentially life-threatening condition.
Keywords: primary abdominal pregnancy; laparoscopy; ultrasonography; RMI; embolization; methotrexate