Zelan Xiao,1 Shengfang Long,2 Zhiqiang Yan,1 Zhen Chen,1 Lihui Lin,1 Yawen Cao1 

1Department of Gynecology, Hainan Western Central Hospital, Danzhou City, Hainan Province, People’s Republic of China; 2Department of Obstetrics and Gynecology, Yangpu Economic Development Zone Hospital, Danzhou City, Hainan Province, People’s Republic of China

Correspondence: Yawen Cao, Department of Gynecology, Hainan Western Central Hospital, No. 5, Wuxiang, Xinshijie Garden Community, Danzhou City, Hainan Province, 571700, People’s Republic of China, Tel +86 18876098257, Email caoyw2024yw@163.com

Abstract: Abdominal pregnancy is a rare and life-threatening form of ectopic pregnancy. Although the underlying mechanism of this abnormal disorder is unknown, a number of risk factors have been identified, including pelvic inflammatory disease, history of pelvic surgery, intrauterine device use and previous ectopic pregnancy. Diaphragmatic rupture due to ectopic pregnancy is a rare and life-threatening condition that can lead to massive intraperitoneal haemorrhage and haemorrhagic shock. This report presents the case of a 21-year-old woman who presented with 7 weeks and 4 days of amenorrhoea and 14 hours of acute abdominal pain. On examination, she was in haemorrhagic shock with signs of acute abdomen. Emergency exploratory laparotomy revealed a haemoperitoneum of 1500 mL and active bleeding from a 3× 2 cm rupture in the right hemidiaphragm. Haemostasis was achieved and the patient recovered well post-operatively. This case highlights the importance of considering diaphragmatic rupture in the differential diagnosis of acute abdomen and haemorrhagic shock, especially in patients with ectopic pregnancy.

Keywords: abdominal pregnancy, ectopic pregnancy, diaphragmatic pregnancy