Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2021; 9(36): 11437-11442
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11437
Ectopic pregnancy implanted under the diaphragm: A rare case report
Qiang-Le Wu, Xiao-Man Wang, Dong Tang
Qiang-Le Wu, Dong Tang, Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Xiao-Man Wang, Department of Ultrasound, The Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Author contributions: Wu QL managed the report and wrote the manuscript; Wang XM collected the clinical data; Tang D revised the manuscript for important intellectual content.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong Tang, MD, Associate Chief Physician, Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Hangzhou 310015, Zhejiang Province, China. tangdong1000@sina.com
Received: July 15, 2021
Peer-review started: July 15, 2021
First decision: September 28, 2021
Revised: October 8, 2021
Accepted: November 18, 2021
Article in press: November 18, 2021
Published online: December 26, 2021
Processing time: 161 Days and 11.4 Hours
Abstract
BACKGROUND

Abdominal pregnancy is a rare type of ectopic pregnancy. We describe here a case of ectopic pregnancy implanted under the surface of the diaphragm, presenting the particular features of imaging findings from ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI).

CASE SUMMARY

A 30-year-old woman presented with complaint of intermittent abdominal pain, that had begun 5 d earlier. She had no current or abnormal vaginal bleeding, and her serum human chorionic gonadotropin level (13372.08 IU/L) indicated pregnancy. Vaginal ultrasound showed a mixed echogenic mass in the right ovary. CT (plain) scan showed a curved high density mass beneath the subhepatic space. MRI scan showed a curved mixed signal, with restricted diffusion beneath the subhepatic space. Abdominal ultrasound demonstrated a mixed echogenic mass in the right lobe of the liver near the apex of the diaphragm, with a visible yolk sac and germ cell region with a bud. Subsequent laparoscopy visualized a dark red mass under the right diaphragm, which was resected completely. Histopathological examination of the resected mass confirmed an ectopic pregnancy. The recovery was swift and uneventful, and the patient was discharged to home.

CONCLUSION

Ectopic pregnancy should be in the differential diagnostic workup (via multiple imaging modalities) of childbearing woman with unexplained abdominal pain.

Keywords: Ectopic pregnancy; Diaphragmatic; Ultrasonography; Computed tomography; Magnetic resonance; Case report

Core Tip: Diaphragmatic pregnancy is an extremely rare type of ectopic pregnancy and is easily misdiagnosed in practice. Here, we report a 30-year-old woman who experienced 5 d of intermittent abdominal pain, without bleeding, and was diagnosed with ectopic pregnancy implanted under the surface of diaphragm. Inclusion of vaginal and abdominal examinations by various routine imaging modalities (ultrasound, computed tomography and magnetic resonance imaging) will to help improve recognition of the disease and reduce clinical error.