Introduction:

Heterotopic pregnancy (HP) is an uncommon yet interesting condition with a high mortality rate despite its low incidence. It can be difficult to diagnose due to its diverse clinical manifestations.

Case presentation.

A 32-year-old, mestizo, pregnant woman from Pasto (Colombia) attended the emergency department of a tertiary care institution due to diffuse abdominal pain associated with vaginal bleeding. Taking into account the imaging findings (ultrasound) and the gonadotropin levels found, the patient was diagnosed with heterotopic pregnancy in right fallopian tube that required surgical treatment by laparotomy. Eight days after the procedure, the patient attended a follow-up appointment during which an ultrasound showed continuity of intrauterine pregnancy.

Conclusions.

The mainstay for the diagnosis of heterotopic pregnancy is clinical suspicion, but it is necessary to confirm it through diagnostic aids such as ultrasound and the measurement of human chorionic gonadotropin levels. A heterotopic pregnancy should be suspected in patients with abdominal pain, even if they do not have risk factors for this type of pregnancy. Choosing medical or surgical treatment will depend on the clinical and hemodynamic condition of the patient and the location and size of the ectopic pregnancy.

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