Laparoscopic management of early primary omental pregnancy.

OBJECTIVE

To describe the successful laparoscopic management of an omental pregnancy.

DESIGN

Case report.

SETTING

University of Schleswig-Holstein, Campus Luebeck, Department of Gynecology and Obstetrics.

PATIENT(S): A 25-year-old patient with an omental pregnancy.

INTERVENTION(S): Laparoscopic partial omentectomy.

MAIN OUTCOME MEASURE(S): Successful laparoscopic management of an omental pregnancy.

RESULT(S): A 25-year-old woman reported having abdominal pain. Her urine pregnancy test was positive. She had been using an intrauterine copper device for a period of 2.5 years. Gynecologic examination revealed normal results, in the uterus and fallopian tubes especially, where no signs of pregnancy were found through clinical and sonographic examination. Because the patient had had increasing pain, a laparoscopy was performed. There was approximately 500 mL of dark blood found in the cul de sac. The uterus and fallopian tubes appeared normal and without any signs of pregnancy. However, there was a cavity detected in the omentum majus. A partial omentectomy then was performed laparoscopically. An omental pregnancy was confirmed by beta-hCG-positive trophoblast cells in the omentum majus.

CONCLUSION(S): Omental pregnancy can be rather difficult to identify. If there is no evidence of tubal pregnancy, laparoscopy may help to confirm the diagnosis of omental pregnancy and simultaneously offer minimal invasive therapy.