There is probably no more dramatic incident in the life of a physician than that of the textbook type of ruptured tubal pregnancy. This condition, with its typical history of a missed menstrual period, sharp lancinating pain in the lower part of the abdomen followed by dizziness, weakness and faintness, soreness in the abdomen, and bleeding from the vagina, represents only a small percentage of all the cases of tubal pregnancy. The others, not typical, are at times very difficult to diagnose. There are patients with symptoms and complaints so minor or so bizarre that the physician may actually wonder whether or not there is anything wrong at all. There is no doubt that many cases go undiagnosed and that the effects go unnoticed. Witness as proof of this the number of lithopedions that have been found. With the exception of rupture of a graafian follicle or a corpus luteum
MATHIEU A. THE DIAGNOSIS OF TUBAL PREGNANCY. JAMA. 1937;108(5):366–369. doi:10.1001/jama.1937.02780050022007
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