ARRS 2022 Abstracts

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E2063. Rare Presentations of Ectopic Pregnancy: A Case-Based Review Including a Lithopedion Ectopic
Authors
  1. Meghan Stanton; Upstate Medical University
  2. Katherine Willer; Upstate Medical University
  3. Dmitriy Bakrukov; Upstate Medical University
Background
Ectopic pregnancy remains the number one cause of maternal death in the first trimester, with misdiagnoses potentially leading to hemorrhage and resultant hypovolemic shock. Women with abdominal pain and/or vaginal bleeding who have an abnormal ß human chorionic gonadotropin level should be quickly evaluated using ultrasound. The majority of ectopic pregnancies are located in the fallopian tube, but it is important to be familiar with the most unusual presentations of ectopic pregnancy and their imaging findings to avoid misdiagnosis. Rare forms of ectopic pregnancy can often progress to a much larger size before they are detected and can have more serious complications such as an increased risk of hemorrhage with significant maternal morbidity and mortality.

Educational Goals / Teaching Points
This educational exhibit will review the ultrasound appearance of rare and unusual ectopic cases, with a focus on abdominal ectopic pregnancies. By the end of this exhibit the participant will be familiar with the common pitfalls in imaging and diagnosis of rare ectopic cases, as well as the complications of each type.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We present a brief review of female pelvic anatomy and describe the locations that different types of ectopic pregnancy can occur. We use a case-based approach to review ultrasound findings in rare ectopic cases and the possible complications of each type. We discuss risk factors for the development of ectopic pregnancy and common pitfalls in imaging. Special focus will be on the most unusual form – abdominal ectopic pregnancy, with an original case of a lithopedion ectopic pregnancy.

Conclusion
Ectopic pregnancy is a dangerous condition that requires prompt recognition and treatment to avoid significant morbidity and mortality. The radiologist plays a pivotal role in the diagnosis of ectopic pregnancy and should be familiar with the most unusual presentations and their associated complications.