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Case Reports
. 2022 Oct 3;14(10):e29881.
doi: 10.7759/cureus.29881. eCollection 2022 Oct.

Not Like the Textbook: An Atypical Case of Ectopic Pregnancy

Eleanor M Birch  1 , Marcos Torres Molina  1 , Joshua J Oliver  1
Affiliations
Case Reports

Not Like the Textbook: An Atypical Case of Ectopic Pregnancy

Eleanor M Birch et al. Cureus. .

Abstract

Ectopic pregnancy is a potentially life-threatening outcome of pregnancy that occurs with the implantation of an embryo outside of the endometrial cavity. Classically considered a "must not miss" diagnosis, ectopic pregnancy is a common emergency department presentation, associated with a symptom triad of amenorrhea, vaginal bleeding, and abdominal pain. However, varied presentations of ectopic pregnancy or lack of typical risk factors can complicate the evaluation and diagnosis of this condition. This case report describes an atypical presentation of ectopic pregnancy after a reported spontaneous abortion, in which the patient was initially discharged with a diagnosis of pelvic inflammatory disease. This case provides an illustration of ectopic pregnancy that presented without classically associated symptoms, and also highlights how anchoring bias and pre-emptive closure, among other cognitive biases, contributed to a missed diagnosis.

Keywords: anchoring bias; cognitive bias; ectopic pregnancy; emergency medicine; premature closure.

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Conflict of interest statement

The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government. The investigators have adhered to the policies for protection of human subjects as prescribed in 45 CFR 46.

Figures

Figure 1
Figure 1. Transvaginal ultrasound of the patient's right adnexa, with heterogenous mass identified (arrow).
See this image and copyright information in PMC

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