{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:53Z","timestamp":1756339613459,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,2,16]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>In this report, we present a case of a woman admitted in her first trimester of pregnancy with significant intraperitoneal haemorrhage from a left tubal stump remnant occurring concurrent to a viable intrauterine pregnancy. The patient was resuscitated and treated successfully with laparoscopic removal of her stump remnant to achieve haemostasis. However, despite extensive investigation, the pathology of her haemorrhagic stump remained inconclusive. Stump ectopic pregnancy is an established phenomenon, although it presents a diagnostic challenge when occurring as a heterotopic pregnancy. Further, persisting trophoblastic tissue is a rare but established feature of incomplete removal of ectopic pregnancy post salpingectomy. Here, we discuss challenges of diagnosis in such cases and present a case report of a presumed stump remnant heterotopic pregnancy from spontaneous conception.<\/jats:p>","DOI":"10.1136\/bcr-2023-258983","type":"journal-article","created":{"date-parts":[[2024,3,12]],"date-time":"2024-03-12T13:46:27Z","timestamp":1710251187000},"page":"e258983","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic resection of a salpingectomy stump remnant during early pregnancy: the diagnostic challenge posed in diagnosing a heterotopic stump pregnancy"],"prefix":"10.1136","volume":"17","author":[{"given":"Isabel","family":"Dighero","sequence":"first","affiliation":[{"name":"University College London, London, UK"},{"name":"Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liam","family":"Shipsey","sequence":"additional","affiliation":[{"name":"University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Elrayes","sequence":"additional","affiliation":[{"name":"University College London, London, UK"},{"name":"Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,3,12]]},"reference":[{"key":"2025082711441589000_17.3.e258983.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.d3397","article-title":"Diagnosis and management of ectopic pregnancy","volume":"342","author":"Jurkovic","year":"2011","journal-title":"BMJ"},{"key":"2025082711441589000_17.3.e258983.2","doi-asserted-by":"crossref","DOI":"10.1186\/s40738-015-0008-z","article-title":"Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review","volume":"1","author":"Panelli","year":"2015","journal-title":"Fertil Res Pract"},{"key":"2025082711441589000_17.3.e258983.3","unstructured":"RCOG . Diagnosis and management of ectopic pregnancy: green top guideline no.21. London: RCOG, 2016. Available: https:\/\/www.rcog.org.uk\/guidance\/browse-all-guidance\/green-top-guidelines\/diagnosis-and-management-of-ectopic-pregnancy-green-top-guideline-no-21\/"},{"key":"2025082711441589000_17.3.e258983.4","doi-asserted-by":"crossref","first-page":"333","DOI":"10.18203\/2320-1770.ijrcog20205792","article-title":"Salpingectomy for ectopic pregnancy: does length really matter","volume":"10","author":"Gaughran","year":"2020","journal-title":"Int J Reprod Contracept Obstet Gynecol"},{"key":"2025082711441589000_17.3.e258983.5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0015-0282(16)58378-2","article-title":"Heterotopic pregnancy after ovulation induction and assisted reproductive technologies: a literature review from 1971 to 1993","volume":"66","author":"Wallach","year":"1996","journal-title":"Fertility and Sterility"},{"key":"2025082711441589000_17.3.e258983.6","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.ejogrb.2021.09.031","article-title":"The rising incidence of heterotopic pregnancy: current perspectives and associations with in-vitro fertilization","volume":"266","author":"Maleki","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"2025082711441589000_17.3.e258983.7","doi-asserted-by":"crossref","first-page":"2432","DOI":"10.1016\/j.fertnstert.2011.03.069","article-title":"Six cases of Tubal stump pregnancy: complication of assisted reproductive technology?","volume":"95","author":"Ko","year":"2011","journal-title":"Fertil Steril"},{"key":"2025082711441589000_17.3.e258983.8","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.rbmo.2012.10.006","article-title":"Unusual case of recurrent heterotopic pregnancy after bilateral salpingectomy and literature review","volume":"26","author":"Shavit","year":"2013","journal-title":"Reprod Biomed Online"},{"key":"2025082711441589000_17.3.e258983.9","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/j.0001-6349.2004.00375.x","article-title":"Risk factors for persistent trophoblastic activity after surgery for ectopic pregnancy","volume":"83","author":"Nathorst-B\u00f6\u00f6s","year":"2004","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025082711441589000_17.3.e258983.10","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1016\/j.jmig.2020.07.008","article-title":"Laparoscopic management of a heterotopic pregnancy in the Tubal stump","volume":"28","author":"Balafoutas","year":"2021","journal-title":"J Minim Invasive Gynecol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258983","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:44:24Z","timestamp":1756320264000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258983"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":10,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3,12]]},"published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1136\/bcr-2023-258983"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258983","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,3]]}}}