Retroperitoneal Ectopic Pregnancy: Technical Management

BACKGROUND: Retroperitoneal ectopic pregnancy is a rare form of ectopic pregnancy, accounting for less than 1% of all cases. This location carries a high risk of massive hemorrhage due to its proximity to major retroperitoneal vessels. CASE PRESENTATION: A 24-year-old female patient, G1P1, presented with a 2-week history of abdominal pain, which had exacerbated in the last 24 hours, accompanied by fever. Laboratory tests revealed elevated serum β-hCG levels (89,331 IU/L), anemia (Hb 8.1 g/dL), and leukocytosis. Abdominal ultrasonography and computed tomography (CT) identified a heterogeneous retroperitoneal mass anterior to the left psoas muscle, consistent with an ectopic pregnancy. An exploratory laparotomy was performed, with the successful removal of the gestational sac and embryo. METHODS: A retrospective review of the medical records of a patient diagnosed with a retroperitoneal ectopic pregnancy was performed. Demographic data, clinical findings, imaging studies (ultrasonography and CT), intraoperative findings, and postoperative follow-up were analyzed. A literature search was conducted across databases (PubMed, SciELO) to compare the case with current literature. CONCLUSION: Retroperitoneal ectopic pregnancy is a rare but potentially life-threatening entity that requires early diagnosis via serum β-hCG and imaging studies (ultrasound, CT), as well as immediate surgical treatment to prevent catastrophic complications.