{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:59:44Z","timestamp":1789196384275,"version":"build-2803163510"},"reference-count":26,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,10,18]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>An ectopic pregnancy occurs in 2% of all pregnancies. A primary ovarian ectopic (OP) is a rare entity and occurs in &lt;2% of all ectopic gestations. It may present in those individuals who take ovulatory drugs, use an intrauterine device or have undergone in vitro fertilisation or embryo transfer. Multiparity and a younger age are other recognised risk factors. Diagnosing an OP pregnancy remains a challenge and it may be misdiagnosed as a bleeding luteal cyst, a haemorrhagic ovarian cyst or a tubal pregnancy by ultrasound scan. The diagnosis is often only established at laparoscopy following histopathological examination. A ruptured OP is a potentially life-threatening condition due to its potential for haemorrhage and hemodynamic collapse. Hence, early diagnosis is crucial to prevent serious morbidity and mortality. The authors present the case of a multiparous woman in her late 30s presenting with a seizure and lower abdominal pain at 6 weeks gestation. Her beta human chorionic gonadotropin was &gt;9000 Miu\/mL. A transvaginal ultrasound scan showed no evidence of an intrauterine pregnancy. There was free fluid in the pelvis. She was hemodynamically stable. She underwent a diagnostic laparoscopy, which showed hemoperitoneum and a ruptured left OP pregnancy. She underwent a left oophorectomy. Histology confirmed chorionic villi within the ovarian stroma. This case demonstrates the challenges in preoperative diagnosis of a ruptured OP pregnancy and acts as a cautionary reminder that individuals can present with hemodynamic stability. Rarely, as in this case, an OP pregnancy can occur without the presence of risk factors. Despite its rarity, a ruptured OP pregnancy should be considered in the differential diagnosis of women of reproductive age presenting to the emergency department with acute abdominal pain and a positive pregnancy test.<\/jats:p>","DOI":"10.1136\/bcr-2022-252499","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T11:17:47Z","timestamp":1671448667000},"page":"e252499","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Ruptured ovarian ectopic pregnancy presenting with an acute abdomen"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5499-415X","authenticated-orcid":false,"given":"Louise","family":"Dunphy","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Leighton Hospital, Crewe, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Leighton Hospital, Crewe, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Hallchurch","sequence":"additional","affiliation":[{"name":"Department of Histo-Pathology, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Staffordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gill","family":"Douce","sequence":"additional","affiliation":[{"name":"Department of Histo-Pathology, Royal Stoke University Hospital, University Hospitals of North Midlands NHS Trust, Staffordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanthi","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Leighton Hospital, Crewe, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,19]]},"reference":[{"key":"2025082707232445000_15.12.e252499.1","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/S0140-6736(05)67103-6","article-title":"Ectopic pregnancy","volume":"366","author":"Farquhar","year":"2005","journal-title":"The Lancet"},{"key":"2025082707232445000_15.12.e252499.2","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(92)90235-Q"},{"key":"2025082707232445000_15.12.e252499.3","first-page":"77","article-title":"Ovarian pregnancy associated with pelvic adhesions","volume":"86","author":"Ciortea","year":"2013","journal-title":"Clujul Med"},{"key":"2025082707232445000_15.12.e252499.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-015-0613-1","article-title":"Risk factors for ectopic pregnancy: a multi-center case-control study","volume":"15","author":"Li","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025082707232445000_15.12.e252499.5","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/PGP.0000000000000482","article-title":"Primary ovarian pregnancy: a case series and analysis","volume":"38","author":"Wang","year":"2019","journal-title":"Int J Gynecol Pathol"},{"key":"2025082707232445000_15.12.e252499.6","doi-asserted-by":"crossref","DOI":"10.1186\/s13256-022-03403-w","article-title":"Successful management of a patient with ovarian ectopic pregnancy by the end of the first trimester: a case report","volume":"16","author":"Kasraei","year":"2022","journal-title":"J Med Case Rep"},{"key":"2025082707232445000_15.12.e252499.7","first-page":"26","article-title":"Two cases of primary ectopic ovarian pregnancies","volume":"10","author":"Gon","year":"2011","journal-title":"Online J Health Allied Sci"},{"key":"2025082707232445000_15.12.e252499.8","first-page":"825","article-title":"Ovarian ectopic pregnancy: a 10 years' experience and review of literature","volume":"12","author":"Goyal","year":"2014","journal-title":"Iran J Reprod Med"},{"key":"2025082707232445000_15.12.e252499.9","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.ijgo.2012.06.008","article-title":"Twenty-One years of experience with ovarian ectopic pregnancy at one institution in Taiwan","volume":"119","author":"Ko","year":"2012","journal-title":"Int J Gynaecol Obstet"},{"key":"2025082707232445000_15.12.e252499.10","doi-asserted-by":"crossref","first-page":"462","DOI":"10.5468\/ogs.2017.60.5.462","article-title":"Preoperative diagnostic clues to ovarian pregnancy: retrospective chart review of women with ovarian and tubal pregnancy","volume":"60","author":"Seo","year":"2017","journal-title":"Obstet Gynecol Sci"},{"key":"2025082707232445000_15.12.e252499.11","unstructured":"Voedisch AJ , Frederick CE , Nicosia AF . 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