In view of the ultrasound findings, the patient underwent laparoscopic surgery. Intra-operatively, a normal right tube and right ovary were seen. A hemoperitoneum of approximately 100 mL was noted in the Pouch of Douglas. An ampullary left ectopic pregnancy was noted. A left-sided salpingectomy was performed. The pathology specimen demonstrated a fallopian tube, with on dissection revealed two haemorrhagic nodules with trophoblastic tissue surrounding them, probably representing the two embryonic poles. Peripheral adhesions of parietal peritoneum to the liver were also seen (Fitz Hugh-Curtis