CLINICAL CASE: Ruptured tubal ectopic pregnancy with hemoperitoneum: laparoscopic resolution, University Hospital, Sucre, Bolivia, October 2025

Abstract

INTRODUCTION: Ectopic pregnancy (EP)
accounts for 1-2% of all pregnancies and is
the leading cause of maternal mortality in the
first trimester. We present a case of ruptured
tubal EP following curettage due to a probable anembryonic pregnancy, highlighting the
diagnostic challenges.
CASE REPORT: A 28-year-old woman presented with severe abdominal pain (VAS
8/10) and transvaginal bleeding 8 days
post-curettage due to a probable anembryonic pregnancy. Ultrasound revealed a right paraadnexal mass with a stillborn fetus
(33x22 mm) and free fluid. Laparoscopy
confirmed ruptured tubal EP with hemoperitoneum (200 ml), and a right salpingectomy
was performed.
DISCUSSION: The diagnosis of EP is complex when it coexists with an anembryonic
pregnancy. Persistent post-curettage pain,
positive hCG, and ultrasound findings are
key. Exploratory laparoscopy is a current alternative for the resolution of ruptured EP.
CONCLUSION: This case emphasizes the
need for active post-curettage surveillance,
especially with persistent symptoms. EE
should be systematically ruled out in acute
pelvic pain with a recent history of miscarriage.