Multimodality imaging techniques of diaphragmatic ectopic pregnancy: a case report and review of the literature.

Abstract

Background: Abdominal ectopic pregnancy is a rare form of ectopic pregnancy, and diaphragmatic ectopic pregnancy is even rarer. We described a case of an ectopic pregnancy implanted on the diaphragm's surface, diagnosed using multimodality imaging techniques, including ultrasonography, X-ray computed tomography, and magnetic resonance imaging.

Case presentation: A 39-year-old Han Chinese female presented with abdominal pain and was diagnosed with subcapsular hemorrhage of the liver on the basis of computed tomography imaging. The patient had experienced paroxysmal severe pain in the right abdomen, without any history of trauma, vomiting, or diarrhea. Her vital signs were stable, and she did not exhibit signs of hemorrhagic shock. She reported that her last menstrual period ended 13 days before the onset of symptoms and that she had a regular menstrual cycle. However, her blood human chorionic gonadotropin levels were significantly elevated. Based on multimodality imaging techniques, including ultrasonography, computed tomography, and magnetic resonance imaging, ectopic pregnancy was considered as a possible diagnosis. To further investigate, laparoscopic exploration was performed. During the procedure, minimal adherent tissue and a small clot were found on the diaphragm's surface. Histological examination confirmed the clot to be a mixture of chorion and blood. The patient remained stable postoperatively and was discharged 1 week after surgery.

Conclusion: Using multimodality imaging techniques for diagnosis prior to treatment is of great significance for patients with ectopic pregnancy with atypical clinical presentations. These techniques enable clear delineation of tissue planes, thereby facilitating accurate diagnosis and preoperative planning by the surgical team.