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The patient was presented with severe symptoms, including abdominal pain, fever, chills, constipation, and vaginal spotting, leading to her hospital admission. Diagnosis was challenging due to the advanced stage of the pregnancy and its abdominal location, particularly in the Douglas pouch, as detected through ultrasonography. According to anatomical standards, this is an intraperitoneal pregnancy rather than an intra-abdominal pregnancy because the fetus developed in the peritoneal cavity. This case is significant for illustrating the critical need for high clinical suspicion and skilled sonographic evaluation to identify such advanced abdominal pregnancies. The successful management of this case through laparotomy, despite the complexities of concurrent conditions, emphasizes the possibility of safe placental removal without increased hemorrhage risk. This report highlights the importance of awareness and expertise in handling rare presentations of ectopic pregnancies, underscoring the potential for positive outcomes with appropriate surgical intervention.<\/jats:p>","DOI":"10.1177\/2050313x241288432","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T10:30:25Z","timestamp":1728383425000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced abdominal pregnancy complicated by pelvic inflammatory disease: A compelling case report"],"prefix":"10.1177","volume":"12","author":[{"given":"Charlotte","family":"El Hajjar","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology Department, Rafik Hariri University Hospital, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hawraa","family":"Mohamad","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences, Obstetrics and Gynecology Resident, Lebanese University, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Siblini","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rafik Hariri University Hospital, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khouloud","family":"Demachkie","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Rafik Hariri University Hospital, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georges","family":"Yared","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Lebanese American University, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department, Rafik Hariri University Hospital, Beirut, Lebanon"},{"name":"Faculty of 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Lebanon"},{"name":"Head of Obstetrics and Gynecology Department, Al Zahraa Hospital University Medical Center, Beirut, Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,7]]},"reference":[{"key":"bibr1-2050313X241288432","doi-asserted-by":"publisher","DOI":"10.1159\/000521733"},{"key":"bibr2-2050313X241288432","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005362"},{"key":"bibr3-2050313X241288432","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2020.07.048"},{"key":"bibr4-2050313X241288432","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2018.32"},{"key":"bibr5-2050313X241288432","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh683"},{"issue":"1","key":"bibr6-2050313X241288432","volume":"5","author":"Masukume G","year":"2014","journal-title":"Obstetr 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