Abstract
Abdominal pregnancy is an uncommon and potentially life-threatening variant of ectopic pregnancy. It involves the implantation of the gestational sac on abdominal organs or the omentum, posing diagnostic and management challenges due to its varied clinical presentations. We present a case of a 34-year-old gravida 7 para 6 woman with progressive lower abdominal pain, initially suspected to have an ovarian ectopic pregnancy based on ultrasound findings. The patient presented with no vaginal bleeding or shoulder tip pain, and her last menstrual period was uncertain due to lactational amenorrhea. A transvaginal ultrasound confirmed an extrauterine pregnancy at 11+2 weeks, with serum beta-human chorionic gonadotropin (BhCG) levels measured at 58818 mIU/ml. During emergency laparoscopy, an abdominal ectopic pregnancy was identified, with placental attachment to the fimbrial end of the fallopian tube and omentum. A salpingectomy was performed while preserving the ovary. This case report highlights the challenges in diagnosing and managing abdominal ectopic pregnancy and emphasises the importance of considering ectopic pregnancy in the differential diagnosis of abdominal pain in women of reproductive age.