Very rare cause for free fluid in abdomen in a pregnant woman. Rupture of an ectopic pregnancy in an unknown situation of Gemini

Case report: A 32 year old (pregnant) woman was admitted to the hospital with pain throughout the whole abdomen. (Pregnancy is known). The initial ultrasound scan detected fetal heart beating in an appropriate sized fetus in the uterine cavity and free fluid in the perihepatic space, in the Morrison pouch and in the lower left abdomen. Intense pain and abdominal guarding was present in all four quadrants. Initial blood tests: Hb 12.5 g/dl declining to 11.1 g/dl two hours later. Results: A laparoscopic operation was performed immediately. The surgical field showed a ruptured right tube with large amounts of clott…