Heterotopic pregnancy is defined as coexistence of intrauterine and ectopic pregnancy at the sametime. It although common with assisted reproductive techniques is very rare in natural conception. Rupturedectopic pregnancy carries a significant maternal mortality and morbidity, so timely diagnosis and managementis crucial. We report a case of heterotopic pregnancy in a 26 year old woman presented with acute abdomen.Immediate surgical intervention was done with diagnosis of ruptured ectopic pregnancy. This case suggeststhat intrauterine gestational sac may be a false reassurance, especially in women presenting a pelvic pain.Heterotopic pregnancy can occur in the absence of any predisposing risk factors. Early diagnosis is necessaryfor the best maternal and intrauterine fetus outcome, hence every physician should be aware of the possibilityof heterotopic pregnancy.
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