Diagnostic Challenges and Emergency Management of Ruptured Ovarian Ectopic Pregnancy: A Case Report

Ovarian ectopic pregnancy (OEP) is an exceptional form of ectopic pregnancy, posing a diagnostic challenge due to its rarity and the similarity of its clinical manifestations to other tubal locations. We report the case of a 36-year-old multiparous patient admitted to the emergency department for acute abdominal pain radiating to the shoulder, associated with signs of hemodynamic shock. Transabdominal ultrasound revealed peritoneal effusion and an empty uterus, suggesting a ruptured ectopic pregnancy. An emergency laparoscopy identified a ruptured left ovarian pregnancy, treated by partial resection of the ovary. The diagnosis was confirmed by histopathological examination, and the postoperative course was favorable, with a rapid decrease in β-HCG levels. This case highlights the potential severity of ruptured OEPs and underscores the necessity of early diagnosis and rapid surgical management in cases of hemodynamic instability. To better understand the clinical, diagnostic, and therapeutic particularities of this rare implantation site, we propose a review of the literature.