Successful medical treatment of a hepatic pregnancy: a case report

BACKGROUND: Hepatic pregnancy is a rare form of abdominal pregnancy, often documented only as case reports. CASE PRESENTATION: We report here the case of a 24-year-old African woman, gravida 4 para 3, presenting with right upper quadrant pains and metrorrhagia after amenorrhea of 8 weeks 5 days. Elements in favor of the diagnosis of hepatic pregnancy were her clinical presentation, the kinetics of β-human chorionic gonadotropin titers, and the presence of a sub-hepatic mass on ultrasound. We successfully treated this patient with intramuscular methotrexate only. CONCLUSIONS: The interest of this case resides in the rarity of this condition and the therapeutic approach used. Clinicians should raise their index of suspicion for hepatic pregnancy when faced with females of reproductive age with such a clinical presentation.