title: A rare case of chronic ectopic pregnancy presenting as large hematosalpinx.
abstract: Ectopic pregnancy is defined as implantation and subsequent development of an embryo outside the uterine lining. It has wide range of presentation from acute hemoperitoneum to chronic ectopic pregnancy. This is an unusual case of chronic ectopic pregnancy with large hematosalpinx without classical symptoms. A 22-year-old South Indian woman reported to the outpatient clinic with irregular spotting for a duration of 2 months which was not associated with pain. There was no preceding amenorrhea and previous menstrual cycles were regular. Clinically, the patient was hemodynamically stable but severely anemic. The abdomen was soft on palpation, cervical movements were not tender, and human chorionic gonadotropin was absent in the urine. Ultrasound revealed a complex adnexal mass. Magnetic resonance imaging (MRI) revealed a large hematosalpinx. Laparoscopic left salpingectomy was conducted and histopathology confirmed ectopic pregnancy. Ectopic pregnancy presents diagnostic dilemmas in the absence of classical symptoms. MRI and laparoscopy are important tools in such a diagnostic dilemma.
authors.affiliation: Department of Obstetrics and Gynecology, Kamineni Institute of Medical Sciences, Narketpally, Andhra Pradesh, India.
authors.forename: Madhavi
authors.initials: M
authors.lastname: Nacharaju
authors.affiliation: Professor Obstetrics and Gynecology Dr Pinnamaneni Siddartha Institute of Medical Sciences & Research Foundation, Chinnoutpalli, Gannavarum Krishna (dist), Andhra Pradesh, India.
authors.forename: Venkata Sujatha
authors.initials: VS
authors.lastname: Vellanki
authors.affiliation: Professor General Surgery Dr Pinnamaneni Siddartha Institute of Medical Sciences & Research Foundation, Chinnoutpalli, Gannavarum Krishna (dist), Andhra Pradesh, India.
authors.forename: Sarath Babu
authors.initials: SB
authors.lastname: Gillellamudi
authors.affiliation: Department of Radiodiagnosis, Institute of Medical Sciences, St Michael's Hosptial, Toronto, Canada.
authors.forename: Vamsi Krishna
authors.initials: VK
authors.lastname: Kotha
authors.affiliation: Department of Obstetrics and Gynecology, Kamineni Institute of Medical Sciences, Narketpally, Andhra Pradesh, India.
authors.forename: Abhinaya
authors.initials: A
authors.lastname: Alluri
keywords: chronic ectopic; hematosalpinx; laparoscopy