title: Severe intra-abdominal bleeding from neglected omental implantation of ectopic tissue after methotrexate treatment for persistent ectopic pregnancy.
abstract: OBJECTIVE
  To describe a case of severe intra-abdominal bleeding from omental implants after laparoscopic linear salpingostomy for ectopic pregnancy (EP).
  
  
  METHODS
  Case report.
  
  
  METHODS
  A medical center.
  
  
  METHODS
  A 27-year-old woman, presenting 15 days after methotrexate (MTX) treatment for persistent EP (35 days after laparoscopic linear salpingostomy for EP).
  
  
  METHODS
  Partial omentectomy.
  
  
  METHODS
  Serial β-hCG levels after partial omentectomy.
  
  
  RESULTS
  Histopathologic examination confirmed omental pregnancy. Her β-hCG levels decreased rapidly from 1,673 mIU/mL to 1.35 mIU/mL within 14 days after partial omentectomy.
  
  
  CONCLUSIONS
  Persistent EP after laparoscopic linear salpingostomy can occur in the omentum; meticulous clinical follow-up should be performed, especially when IM MTX injection was used as the salvage treatment for persistent EP.
authors.affiliation: Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei City, Taiwan.
authors.forename: Mei-Chu
authors.initials: MC
authors.lastname: Wu
authors.forename: Wen-Chih
authors.initials: WC
authors.lastname: Huang
authors.forename: Ho-Hsiung
authors.initials: HH
authors.lastname: Lin
authors.forename: Sheng-Mou
authors.initials: SM
authors.lastname: Hsiao
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008727:Methotrexate / Q000627:therapeutic use*; D009852:Omentum; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000209:etiology / Q000628:therapy*; D011274:Pregnancy, Tubal / Q000097:blood / Q000628:therapy*; D012086:Reoperation; D012489:Salpingostomy / Q000009:adverse effects* / Q000379:methods; D016879:Salvage Therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate