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February 16, 1979

Upper Abdominal Pain—An Unusual Symptom of Ectopic Pregnancy

Author Affiliations

Miami Valley Hospital Dayton, Ohio

JAMA. 1979;241(7):696. doi:10.1001/jama.1979.03290330016014

To the Editor.—  The majority of patients with ectopic pregnancy are recognized by the symptom triad of amenorrhea, lower abdominal pain, and abnormal vaginal bleeding. Occasionally the diagnosis is difficult because some patients complain of ambiguous symptoms such as dizziness, shoulder pain, nausea, or urinary frequency. I present a case of ruptured ectopic pregnancy in a patient who had no symptoms referable to the pelvis or lower abdomen.

Report of a Case.—  A 30-year-old woman, para 1, was admitted to the hospital with a 12-hour history of nausea, vomiting, diarrhea, and epigastric pain, which had begun suddenly during coitus. For one week before admission she had experienced nausea and epigastric pain radiating around both flanks. Her last menses had occurred eight weeks before, and she suspected that she was pregnant. There had been no vaginal spotting. Past history was notable in that she had undergone appendectomy and right ovarian cystectomy