Bilateral tubal ectopic pregnancy with live right ampullary gestation and contralateral occult tubal ectopic pregnancy: A rare case report

Abstract

Bilateral tubal ectopic pregnancy is an exceptionally rare form of ectopic gestation, with an estimated incidence of 
approximately 1 in 200,000 pregnancies. Diagnosis is often challenging because clinical and radiological findings 
usually identify only one ectopic pregnancy preoperatively, whereas the contralateral lesion remains undetected until 
surgery. We report a case of a 25-year-old female, G3P1L1A1, who presented at 6 weeks 2 days of gestation with 
abdominal pain and vaginal bleeding. Ultrasonography revealed a live right tubal ectopic pregnancy with fetal cardiac 
activity. Laparoscopic evaluation demonstrated a right ampullary ectopic pregnancy with active bleeding through the 
fimbrial end and an unexpectedly dilated left fallopian tube suspicious for concomitant ectopic gestation. Bilateral 
salpingectomy was performed. Histopathological examination confirmed bilateral tubal ectopic pregnancy with 
associated hydrosalpinx of the left tube. This case highlights the importance of meticulous inspection of both adnexa 
during surgical management of ectopic pregnancy.