Is ectopic pregnancy possible after hysterectomy?

Objective: To determine whether ectopic pregnancy should be suspected in young women with abdominal pain even after hysterectomy. Design: Case report. Setting: The patient presenting with abdominal pain in the emergency department was referred to a tertiary care center. Patient(s): A young woman who had had a subtotal hysterectomy 3 years prior for atonic postpartum hemorrhage during her last caesarean section presented with acute abdominal pain. Intervention(s): Urgent ultrasound showed a gestational sac of 9 weeks + 3 days. Emergency laparotomy was done for suspected ectopic pregnancy. Main Outcome Measure(s): Ultrasound, operative findings, and histopathology. Result(s): Tubal ectopic pregnancy was confirmed on laparotomy and histopathology. Conclusion(s): Early suspicion can avoid missing early and treatable ectopic gestation before life-threatening complications develop. (Fertil Steril (R) 2010; 94: 350. e5-e7. (C) 2010 by American Society for Reproductive Medicine.)