A spontaneous bilateral fallopian tube pregnancy with didelphic uterus: A case report

RATIONALE: In this article, we report interesting clinical manifestation of spontaneous bilateral fallopian tube pregnancies in a patient with a didelphic uterus. PATIENT CONCERNS: A 26-year-old female patient, gravida 2, para 0 + 1, suffered from progressive abdominal pain and vaginal bleeding. A laboratory exam revealed a human chorionic gonadotropin level of 1091 IU/L. Transvaginal ultrasound detected no embryo sacs in the uterus but revealed a didelphic uterus, and a mass measuring 39 mm x 32 mm in the left adnexa region with another mass measuring 42 x 28 mm in the right adnexa region. DIAGNOSES: An ectopic pregnancy in the left adnexa region and a corpus hemorrhagicum in the right adnexa region were suspected. INTERVENTIONS: Laparoscopic exploration operation confirmed a didelphic uterus, and pathological biopsy revealed bilateral fallopian tube pregnancies. OUTCOMES: The patient made a good recovery and the human chorionic gonadotropin became normal within the following 2 months. LESSONS: To the best of our knowledge, clinical manifestation of spontaneous bilateral fallopian tube pregnancies in a patient with a didelphic uterus has never been reported before. Based on the experience with this case, we suggest that if a gestational sac is found in 1 fallopian tube, the contralateral fallopian tube needs to be examined for an ectopic pregnancy during surgery.