Primary rectal ectopic pregnancy: a rare case report and literature review

Patients with rectal ectopic pregnancy often present with nonspecific early symptoms, leading to frequent misdiagnosis or delayed diagnosis. Definitive diagnosis is typically established only after the onset of severe complications. Through a multidisciplinary approach to this rare case and a systematic review of the literature, we have derived the following important clinical insights: 1. Early diagnosis strategy: early identification of REP requires a multimodal approach, including dynamic monitoring of serum β-hCG levels, pelvic ultrasound, and multimodal imaging assessment with CT/MRI. Diagnostic laparoscopy should be performed when necessary to confirm the location and extent of the lesion. 2. Broadening differential diagnosis considerations: in all women of childbearing age who are considered to be pregnant, especially when intrauterine, tubal, or ovarian pregnancy is not detected by ultrasound, REP should be included in the differential diagnosis. 3. Value of Minimally Invasive Surgery: Single-port laparoscopic surgery has demonstrated comprehensive advantages in such emergency surgeries, including minimal invasiveness, rapid recovery, and cosmetic benefits. However, this technique requires the surgeon to possess advanced skills, and the patient must meet the indications for single-port laparoscopic surgery. This article also provides important reference evidence for the development of standardized diagnostic and treatment protocols for rectal ectopic pregnancy.