Omental Implantation, Mesenteric Defect, and Bilateral Ovarian Cysts Post Salpingectomy for Ruptured Tubal Ectopic Pregnancy

This study describes a rare case of omental implantation of gestational tissue with a mesenteric defect in an intestinal segment and large bilateral multiseptate clear ovarian cysts in a 31-year-old patient who presented 32 days after laparoscopic salpingectomy for a ruptured tubal ectopic pregnancy, manifesting with acute abdomen. The patient underwent partial omentectomy, bilateral ovarian cystectomy, and segmental intestinal resection with side-to-side anastomosis. Serial β-HCG monitoring post-partial omentectomy revealed a rapid decline, confirming successful removal of trophoblastic tissue. Histopathological examination confirmed omental pregnancy. This case underscores the importance of caution during laparoscopic procedures to prevent omental implantation, advocating for meticulous extraction of trophoblastic tissue, preferably using a tissue retrieval bag, and diligent postoperative monitoring with serial β-HCG assays to ensure complete resolution.