Laparoscopic Management of Hemoperitoneum Due to a Cornual Pregnancy After an Ipsilateral Tubal Pregnancy: A Case Report

Background: Cornual pregnancy (CP) is a rare but life-threatening form of ectopic pregnancy. Severe complications include uterine rupture and massive hemorrhage, often requiring complex surgical management despite prompt intervention. We report a case of a ruptured left CP at 12 weeks, occurring three months after ipsilateral salpingectomy for a tubal pregnancy. Case Presentation: A 27-year-old woman, gravida 2, with a history of left salpingectomy, presented at 12 weeks of amenorrhea with severe pelvic pain and irregular uterine bleeding. Clinical examination, serum β-hCG testing, and transvaginal ultrasound confirmed hemoperitoneum due to rupture of a cornual pregnancy. Emergency laparoscopy was performed, with drainage of massive hemoperitoneum, excision of the ectopic gestation, and uterine wall repair. Uterine integrity was preserved, and the patient was discharged without complications. Discussion: Cornual ectopic pregnancy remains diagnostically and surgically challenging, with high risk of catastrophic hemorrhage. Transvaginal ultrasonography, supported by 3D ultrasound or MRI in equivocal cases, facilitates early diagnosis. Laparoscopy is increasingly recognized as the gold standard, offering reduced morbidity, faster recovery, and preservation of fertility compared with laparotomy, though it requires advanced surgical expertise. Long-term follow-up is essential due to the risk of uterine rupture in subsequent pregnancies, and elective cesarean delivery is often advised. Conclusion: This case demonstrates that minimally invasive laparoscopic management of ruptured CP with massive hemoperitoneum is feasible and safe when performed by experienced surgeons, but further studies are needed to optimize standardized protocols and assess reproductive outcomes.