Ruptured primary intrahepatic ectopic pregnancy: A case report and review of literature

Figure 1 Abdominal ultrasound. A: Ultrasound imaging demonstrated a large volume of free intraperitoneal fluid that was consistent with massive hemoperitoneum; B: Live ectopic pregnancy with positive fetal heart rate. Doppler study showed intracardiac color flow; C: Focused abdominal ultrasonography of the liver. Ultrasound imaging showed a heterogeneous lesion with mixed echogenicity arising from the right hepatic lobe that was suspicious of ectopic gestational implantation.

Figure 2 Intraoperative findings during diagnostic laparoscopy. Intraoperative view of active bleeding from a ruptured gestational mass embedded within the hepatic parenchyma (arrows).

Figure 3 Surgical specimen. Excised ectopic gestational tissue obtained from the liver surface following surgical hemostasis.

Figure 4 Histopathological examination. Microscopic image of chorionic villi embedded within the hepatic tissue, confirming the diagnosis of intrahepatic ectopic pregnancy (hematoxylin and eosin staining, × 100).

Figure 5 Histopathological examination. A: Magnification (× 40) magnification of hepatocytes (black arrow) and chorionic villi (orange arrow) with peripheral area of necrosis and hemorrhage; B: Cytotrophoblasts visualized (orange arrow) along with inflammatory infiltrates. S: Synctiotrophoblasts; H: Hepatocytes; CV: Chorionic villi; C: Cytotrophoblasts.