Ectopic pregnancy implanted under the diaphragm: A rare case report

BACKGROUND: Abdominal pregnancy is a rare type of ectopic pregnancy. We describe here a case of ectopic pregnancy implanted under the surface of the diaphragm, presenting the particular features of imaging findings from ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). CASE SUMMARY: A 30-year-old woman presented with complaint of intermittent abdominal pain, that had begun 5 d earlier. She had no current or abnormal vaginal bleeding, and her serum human chorionic gonadotropin level (13372.08 IU/L) indicated pregnancy. Vaginal ultrasound showed a mixed echogenic mass in the right ovary. CT (plain) scan showed a curved high density mass beneath the subhepatic space. MRI scan showed a curved mixed signal, with restricted diffusion beneath the subhepatic space. Abdominal ultrasound demonstrated a mixed echogenic mass in the right lobe of the liver near the apex of the diaphragm, with a visible yolk sac and germ cell region with a bud. Subsequent laparoscopy visualized a dark red mass under the right diaphragm, which was resected completely. Histopathological examination of the resected mass confirmed an ectopic pregnancy. The recovery was swift and uneventful, and the patient was discharged to home. CONCLUSION: Ectopic pregnancy should be in the differential diagnostic workup (via multiple imaging modalities) of childbearing woman with unexplained abdominal pain.