The study of symptoms of ectopic pregnancy, augmented in this paper by observation of 81 patients treated surgically in the Ravenswood Hospital, Chicago, reveals results interesting not only to the gynecologist but to the surgeon, who faces the problem of differentiating "surgical" from "gynecologic" diseases of the lower part of the abdomen. Laboratory data which make the diagnosis almost specific, such as the Aschheim-Zondek reaction, are not always available, but once the possibility of an ectopic pregnancy is considered, these tests facilitate a more definite diagnosis. Although, as will be explained later, the blood counts are often bare of any diagnostic significance, there will be occasions when the patient's pallor and other manifestations of shock will make a diagnosis of internal hemorrhage definite. The only difficulty will be in determining the source of the hemorrhage; abnormalities in the menstrual history together with other manifestations, to be mentioned later, should lead
ZECHEL G. ECTOPIC PREGNANCY: ITS RELATION TO THE DIAGNOSTIC PROBLEMS OF THE GENERAL SURGEON. Arch Surg. 1940;41(3):646–661. doi:10.1001/archsurg.1940.01210030080007
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