Bilateral Ectopic Pregnancy: A Case Report

This is a clinical case report of a 23-year-old female admitted to St Paul's district hospital in North-East Zambia with a chief complaint of abdominal pain. Her past medical history included amenorrhea for 7 weeks, no vaginal blood loss, a previous delivery in 1986, postpartum abdominal pains which lasted for 3 months. On physical examination, she presented with slight anemia, normal temperature, normal blood pressure and a normal pulse. Pressure applied to the lower abdominal area was painful. Vaginal examination revealed an enlarged uterus; the rectovaginal pouch was extremely sensitive to pressure. Hemoglobin level was 8.5% and a pregnancy test was negative. On Laparotomy, a left sided ampullar tubal was found, with the right tube exhibiting an intact elastic swelling in the isthmus. Right salpingostomy was done to shell out the ectopic gestinal tissue and the left salpingectomy was performed to clean the recto vaginal pouch. The diagnosis made was bilateral ectopic pregnancy. The likely etiology was simultaneous ovulation from both ovaries, fertilization and subsequently implantation. The fallopian tubes had been previously affected by postpartum salpingitis.