Rupture of non-communicating rudimentary horn ectopic pregnancy of a unicornuate uterus in first trimester

Pregnancy in rudimentary horn of a unicornuate uterus is a very rare type of ectopic pregnancy. Ninety percent of cases eventually rupture in the second trimester. Only few cases of rupture of the pregnant rudimentary horn occur during first trimester. A 23 year old primigravida presented with 8 weeks of amenorrhea with acute pain abdomen and vomiting. On examination, the patient was in shock. On ultrasound, unicornuate uterus with ruptured rudimentary horn ectopic pregnancy was suspected. On laparotomy, the diagnosis was confirmed. The rudimentary horn was excised and ipsilateral salpingectomy was done. This case is presented because of rarity of rupture of rudimentary horn ectopic in first trimester and also to emphasize on the importance of recognizing subtle clinical findings which are suggestive of this rare condition.