Volume 10, Issue 4 (2025)
SJMR 2025, 10(4): 179-184 |
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Nami F, Nateghi M R. Ruptured Cornual Ectopic Pregnancy: A Rare Case Managed by Emergency Laparotomy and Sturmdorf Repair. SJMR 2025; 10 (4) : 2
URL: http://saremjrm.com/article-1-380-en.html
URL: http://saremjrm.com/article-1-380-en.html
Ruptured Cornual Ectopic Pregnancy: A Rare Case Managed by Emergency Laparotomy and Sturmdorf Repair
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
Abstract: (328 Views)
Introduction: Cornual ectopic pregnancy is one of the rarest forms of ectopic pregnancy, occurring at the interstitial portion of the fallopian tube where it traverses the muscular wall of the uterus. This type of pregnancy carries a high risk of uterine rupture and massive intra-abdominal hemorrhage and is usually diagnosed at a more advanced gestational age compared with other types of ectopic pregnancies. Early diagnosis is challenging due to its unique anatomical location, and in many cases, patients present with signs of hemodynamic shock.
Case Presentation: A 34-year-old woman, G2P1, during the lactation period, presented to the emergency department of Sarem Hospital with severe abdominal pain and pre-shock symptoms (PR:130; BP:80/50 mmHg). She had a known 12-week intrauterine pregnancy. Ultrasound revealed a large amount of free fluid and clots in the abdominal cavity. The patient underwent emergency laparotomy, during which approximately 2–2.5 liters of blood and clots were found in the peritoneal cavity, along with a 14-week fetus in the abdomen. A ruptured left cornual pregnancy with placental tissue abnormally adherent to the myometrium was identified, consistent with ruptured cornual ectopic pregnancy with placenta accreta. The uterine rupture was repaired using the Sturmdorf technique, and the left fallopian tube was completely removed. After blood transfusion and intensive care, the patient was discharged in good general condition. On follow-up, β-hCG levels were negative and hemoglobin returned to normal.
Conclusion: Cornual pregnancy, due to delayed diagnosis, may result in extensive uterine rupture and life-threatening hemorrhage. Awareness of its clinical features and the use of precise imaging modalities are essential for early diagnosis and prevention of fatal complications. Uterine repair using the Sturmdorf technique can be an effective approach in selected cases, preserving uterine function and ensuring full recovery.
Case Presentation: A 34-year-old woman, G2P1, during the lactation period, presented to the emergency department of Sarem Hospital with severe abdominal pain and pre-shock symptoms (PR:130; BP:80/50 mmHg). She had a known 12-week intrauterine pregnancy. Ultrasound revealed a large amount of free fluid and clots in the abdominal cavity. The patient underwent emergency laparotomy, during which approximately 2–2.5 liters of blood and clots were found in the peritoneal cavity, along with a 14-week fetus in the abdomen. A ruptured left cornual pregnancy with placental tissue abnormally adherent to the myometrium was identified, consistent with ruptured cornual ectopic pregnancy with placenta accreta. The uterine rupture was repaired using the Sturmdorf technique, and the left fallopian tube was completely removed. After blood transfusion and intensive care, the patient was discharged in good general condition. On follow-up, β-hCG levels were negative and hemoglobin returned to normal.
Conclusion: Cornual pregnancy, due to delayed diagnosis, may result in extensive uterine rupture and life-threatening hemorrhage. Awareness of its clinical features and the use of precise imaging modalities are essential for early diagnosis and prevention of fatal complications. Uterine repair using the Sturmdorf technique can be an effective approach in selected cases, preserving uterine function and ensuring full recovery.
Article number: 2
Keywords: Cornual Ectopic Pregnancy, Uterine Rupture, Placenta Accreta, Sturmdorf Technique, Emergency Laparotomy, Interstitial Region (Cornual).
Article Type: Case Report |
Subject:
Women Diseases
Received: 2025/12/6 | Accepted: 2026/01/31 | Published: 2026/02/2
Received: 2025/12/6 | Accepted: 2026/01/31 | Published: 2026/02/2
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