Birch Eleanor M, Torres Molina Marcos, Oliver Joshua J
Department of Emergency Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, USA.
Cureus. 2022 Oct 3;14(10):e29881. doi: 10.7759/cureus.29881. eCollection 2022 Oct.
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.
异位妊娠是一种潜在危及生命的妊娠结局，发生于胚胎在子宫内膜腔外着床时。传统上被视为“绝不能漏诊”的疾病，异位妊娠是急诊科常见的就诊情况，常伴有闭经、阴道出血和腹痛的症状三联征。然而，异位妊娠表现多样或缺乏典型危险因素会使该病的评估和诊断复杂化。本病例报告描述了1例在报告自然流产后出现的非典型异位妊娠表现，该患者最初出院时被诊断为盆腔炎。本病例展示了1例无典型相关症状的异位妊娠情况，同时也强调了诸如锚定偏差和过早结案等认知偏差是如何导致漏诊的。
