Clinical Analysis of Atypical Ectopic Pregnancy Misdiagnosed as Acute Ap-pendicitis

XING Liying; WANG Qiu

doi:10.3969/j.issn.1002-3429.2023.07.004

Abstract：Objective To investigate the clinical characteristics,diagnosis,differential diagnosis,causes of misdiag-nosis and preventive measures of atypical ectopic pregnancy.Methods The clinical data of 9 patients with atypical ectopic pregnancy who were misdiagnosed from April 2021 to July 2022 were retrospectively analyzed.Results There were 6 cases of sudden abdominal pain and 3 cases of persistent dull pain.There were 6 cases of McGlover point tenderness,3 cases of right lower abdomen tenderness,5 cases of rebound pain and 4 cases of abdominal muscle tension.Nine cases had reduced bowel sound and 4 cases had positive Rovsing's sign.Three cases had abdominal mobility dullness.There were 6 cases with elevated white blood cells and 3 cases with mild anemia.Abdominal ultrasound examination showed hypoecho in the right lower abdo-men.All patients were initially diagnosed with acute appendicitis in other hospitals at the early stage of treatment,and was transferred to our hospital for surgical treatment.The duration of misdiagnosis was(14.2±3.1)h.After admission to our hospital for further medical history inquiry,5 cases were diagnosed with ectopic pregnancy by peritoneal puncture and 4 cases by posterior vaginal fornix puncture.All the 9 patients underwent laparoscopic right salpingectomy after diagnosis,and were treated with anti-infection after surgery.They were cured and discharged from hospital at 2-3 d after surgery.Conclusion Early misdiagnosis of atypical ectopic pregnancy is more likely to occur.The receiving doctors in primary hospitals should strengthen their understanding of the disease,improve the vigilance of women of childbearing age with acute abdomen,make detailed inquiries,conduct relevant examinations in time for those suspected of ectopic pregnancy,and comprehensively ana-lyze the condition,so as to reduce or avoid misdiagnosis and mistreatment of the disease.