Case of a chronic ectopic pregnancy misdiagnosed as pelvic inflammatory disease

Abstract

The definition of a chronic ectopic pregnancy (CEP) is poorly defined in the literature and making a timely diagnosis can be incredibly challenging. This is primarily due to its broad range of clinical presentations and conflicting biochemical and sonographic results. Often, CEPs are mistaken for ovarian malignancies, pelvic inflammatory disease (PID), uterine fibroids or endometriosis, therefore, leading to a delayed diagnosis. We present a case report of a woman who was initially misdiagnosed with PID and then later preoperatively diagnosed with a CEP. This case particularly highlights the diagnostic dilemma posed by CEPs and raises awareness of the key clinical symptoms, biochemical and sonographic investigations which in combination can contribute towards making a timely preoperative diagnosis.

Chronic interstitial ectopic pregnancy presenting with a negative urine pregnancy test

“…This makes the diagnosis more difficult because the pregnancy-related conditions are often given low priority in the differential diagnosis, especially if the serum bHCG level is lower than 25 mIU/mL, which might not be detected with a qualitative urine pregnancy test 12. Furthermore, CTP has been shown to mimic a variety of many non-pregnancy-related conditions, including pelvic inflammatory disease, tubo-ovarian abscess, pelvic malignancy and, in this case, uterine leiomyoma with cystic degeneration 10 11 13. Fortunately, in this patient, we had a history of a positive self-sampling pregnancy test, which was critical to the correct diagnosis.…”