An exceptionally rare medical case was recorded last week at the Wolfson Medical Center, where a 40-year-old woman from Holon was diagnosed with an ectopic pregnancy that had implanted in her liver — one of the rarest conditions in gynecological medicine. According to a review of the medical literature conducted by the team treating her, only 47 such cases have been documented worldwide over the past six decades.
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus. In the vast majority of cases, the pregnancy develops in one of the fallopian tubes. In this case, however, the embryo implanted in the liver, an organ rich in blood vessels. Such pregnancies are not viable and can lead to life-threatening internal bleeding if not diagnosed in time.
According to the report, the patient, a mother of two, was unaware that she was pregnant. She sought medical attention after experiencing severe abdominal pain, weakness, and shortness of breath. She said she had menstruated roughly two weeks earlier and therefore had no reason to suspect pregnancy.
Blood tests revealed elevated levels of the pregnancy hormone hCG, but an ultrasound examination showed an empty uterus. Only after further testing were doctors able to locate the gestational sac, which contained a seven-week-old embryo with a heartbeat attached to the liver.
The patient said receiving the diagnosis was deeply distressing and that she feared for her life and the future of her children after learning how dangerous the condition was.
“More than 95% of ectopic pregnancies occur in the fallopian tubes”
According to Prof. Ron Sagiv, head of the Advanced Gynecology Unit at Wolfson Medical Center, the case is among the rarest he has encountered in more than 30 years of medical practice.
Ectopic pregnancies account for approximately 1% to 2% of all pregnancies, he said, but more than 95% develop in the fallopian tubes. A pregnancy implanted in the liver is exceptionally rare.
How did the pregnancy reach the liver?
Doctors believe the egg was fertilized in the fallopian tube but, instead of progressing to the uterus, entered the abdominal cavity, migrated, and ultimately implanted in the liver.
Despite this possible explanation, physicians acknowledge that it remains unclear why, in such extremely rare cases, a fertilized egg is able to implant in organs such as the liver, spleen, or abdominal wall.
Rapid diagnosis and a life-saving operation
Doctors initially suspected a conventional ectopic pregnancy but continued their investigation after finding no pregnancy in the uterus. An ultrasound examination of the upper abdomen ultimately revealed the gestational sac in the liver, leading to an emergency minimally invasive laparoscopic procedure.
During the operation, surgeons removed the gestational sac along with a small portion of the liver tissue to which it was attached, while controlling bleeding and preserving the remaining liver tissue. Physicians noted that, unlike many of the cases described in medical literature that required open surgery, this procedure was successfully performed using a minimally invasive approach, allowing for a faster recovery.
Message to women: “Do not ignore unusual pain”
After recovering from surgery, the patient said she wanted to share a message with other women. “Don’t try to be heroes and don’t assume you know everything,” she said. “If you’re experiencing unusual pain or feel that something isn’t right, go and get checked. It could save your life.”