April 4th, 2020

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Recurrent Pelvic Abscess: An Unusual Presentation of an Undetected Chronic Ectopic Pregnancy: A Case Report
Authors:  Natasha Gupta, M.D., Josef Blankstein, M.D., and Richard Trester, M.D.
BACKGROUND: Abdominal pregnancy is a very rare gynecologic condition. It arises from abdominal implantation of an embryo either primarily or a tubal abortion secondarily. Its presentation as a recurrent pelvic abscess has never been reported before.

CASE: We report a case of recurrent tubo-ovarian abscess in a nulliparous patient that repeatedly failed medical management. These recurrences spanned over a 3-year time period, with each recurrence worse than the last and complete resolution of the condition in between the recurrences. This patient underwent total hysterectomy and was diagnosed with a previously undetected ectopic pregnancy on final pathology, as the cause for her tubo-ovarian abscesses.

CONCLUSION: We hypothesize that an undiagnosed abdominal pregnancy underwent necrosis and subsequent infection, leading to recurrent tubo-ovarian abscesses. This is an unusual and unreported complication of abdominal pregnancies.
Keywords:  ectopic pregnancy, hysterectomy, ovarian abscess, pelvic inflammatory disease, placenta, tubal abscess
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