# Unrecognized abdominal pregnancy with six months’ evolution revealed by acute intestinal obstruction in women with PCOS

## TL;DR

A rare case of abdominal pregnancy in a woman with PCOS was diagnosed after complications from intestinal blockage.

## Contribution

This case highlights the diagnostic challenges of abdominal pregnancy and its unusual presentation.

## Key findings

- Abdominal pregnancy was diagnosed at 20 weeks through abdomino-pelvic scan.
- The fetus caused intestinal and uterine perforation requiring surgical intervention.
- Preoperative diagnosis remains difficult due to non-specific symptoms.

## Abstract

Abdominal pregnancy is a rare form of ectopic pregnancy where implantation and
development of the egg take place in the peritoneal cavity outside the
tubo-uterine mucosa, in contact with intestinal loops. Diagnosis is most often
difficult. We report the case of a 32-year-old woman (gravida 1, para 1), with a
history of PCOS, diagnosed with abdominal pregnancy at 20 weeks of amenorrhea
complicated by acute intestinal obstruction. Diagnosis was confirmed by
abdomino-pelvic scan. Surgery was performed with the patient under general
anesthesia. She presented a macerated fetus with an infiltration of the placenta
causing a perforation of the sigmoid colon and uterus. Hartmann’s procedure was
performed and the perforation of the uterus was sutured. Abdominal pregnancy
remains a rare variety of ectopic pregnancy. Preoperative diagnosis is difficult
due to the presence of a variety of non-specific symptoms. This type of ectopic
pregnancy remains challenging for gynecologists and radiologists.