HOWARD1 lists many diseases in which the serum amylase level may be elevated including ruptured tubal pregnancy.
A search of the literature disclosed a single case report2 of ruptured ectopic pregnancy with elevated serum amylase levels. It is that of a woman, aged 22 years, with acute abdominal pain, abdominal tenderness and rigidity, and a serum amylase level of 1,600 Somogyi units (normal is less than 200 units). A laparotomy was performed and a ruptured tubal pregnancy removed. The pancreas, gallbladder, and liver were normal. The next day the serum amylase was 1,680 units; 14 days later, 360 units; one year later, 300 units; and two years later, 110 units. Cholecystogram, glucose tolerance test, and mumps complement fixation test were normal.
We recently treated a similar case and think it worthwhile reporting, for the abnormal levels of serum amylase led to delay in making the correct diagnosis.
FLEGE JB. Ruptured Tubal Pregnancy With Elevated Serum Amylase Levels. Arch Surg. 1966;92(3):397–398. doi:10.1001/archsurg.1966.01320210077015
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