Recurrent Ectopic Pregnancy in the Remnant Fallopian Tube Following Ipsilateral Partial Salpingectomy

A 39-year-old female with a history of partial salpingectomy for tubal pregnancy was diagnosed as having recurrent ectopic pregnancy in the distal portion of the fallopian tube remnant, which was successfully treated by laparoscopic surgery. The patient was multigravida (9 pregnancies) and uniparous. She had undergone right partial salpingectomy by laparotpmy for right isthmic ectopic pregnancy at the age of 31 years. At 6 weeks of the current pregnancy, she was referred to our hospital for suspected ectopic pregnancy. The gestational sac was not observed in the uterus, and a mass was observed in the right adnexal region by transvaginal ultrasonography. Emergency laparoscopic surgery revealed the pregnancy site in the ampulla of the remnant portion of the right fallopian tube; therefore, this portion was resected. Because the proximal portion of the fallopian tube remnant was completely occluded, we concluded that this was a case of ectopic pregnancy resulting from the intraperitoneal migration of a fertilized ovum. With current developments in assisted reproductive technologies, reanastomosis of the fallopian tube is rarely performed. While partial salpingectomy is less likely to contribute to the preservation of fertility, it increases the risk of recurrent ectopic pregnancy. A single-stage total salpingectomy on the affected side should be the first choice of treatment when fallopian tube preservation surgery is not selected.