Persistent omental trophoblastic implantation following salpingostomy, salpingectomy and methotrexate for ectopic pregnancy: A case report

2% of all pregnancies are ectopic. Optimal surgical management is currently salpingectomy over salpingostomy, secondary to the risks of persistent trophoblastic tissue or omental implants (15%). However, rare cases of omental trophoblastic implants following laparoscopic salpingectomy have been noted in the literature. Current practice dictates that serial determinations of human chorionic gonadotropin (beta-hCG) levels after salpingectomy are not required, as it is considered a definitive treatment. However, given that these cases are hard to interpret through ultrasound and are almost always detected via sudden-onset abdominal pain and acute haemoperitoneum (33%), an argument can be made for post-operative beta-hCG assessment. •A case of persistent trophoblastic omental deposits following attempted salpingostomy and subsequent salpingectomy of an ectopic pregnancy.•Ongoing raised human chorionic gonadotropin (beta-hCG), treated with methotrexate, resulted in haemoperitoneum, requiring operative management.•Follow-up beta-hCG levels following attempted salpingostomy should be routinely performed.