Abdominal Ectopic Pregnancy: A Case Report of an Uncommon Complication of Pregnancy Without Prenatal Care.

Ectopic pregnancy (EP) is a life-threatening condition requiring a high clinical suspicion. This diagnosis must be considered in all female patients of reproductive age presenting with abdominal pain or discomfort who may possibly be pregnant. Ectopic pregnancies occur in a small percentage of all pregnancies and are a significant cause of maternal morbidity and mortality. Abdominal ectopic pregnancy (AEP) is a rare and potentially fatal form of ectopic pregnancy where the implantation occurs in the abdominal cavity. We present the following case of a 23-year-old female who was transferred following an initial workup for abdominal pain and subsequently found to have an abdominal ectopic pregnancy at 37 weeks gestation. After transferring to our emergency department, the patient continued to have abdominal pain and her presenting FAST exam was positive for free fluid concerning for active hemorrhage and hematoma. Her clinical presentation was consistent with ruptured abdominal ectopic pregnancy, and she was taken to the operating room for emergent exploratory laparotomy and delivery. Her clinical course was complicated by adherent placenta and re-bleeding with significant hemoperitoneum requiring re-entry laparotomy and transfusion. We present the details of this case along with the diagnostic imaging and management of the rarely seen and life-threatening condition of secondary abdominal ectopic pregnancy (AEP).

Quantification of doxorubicin-induced interstitial myocardial fibrosis in a beagle model using equilibrium contrast-enhanced computed tomography: A comparative study with cardiac magnetic resonance T1-mapping.

BACKGROUND: The noninvasive equilibrium contrast-enhanced cardiac computed tomography (CCT) has potential for myocardial tissue characterization. The objective of this study was to test the feasibility of CCT-based extracellular volume (ECV) fraction in beagle models of doxorubicin-induced interstitial myocardial fibrosis, with cardiac magnetic resonance (CMR) as the reference. METHODS: This study was approved by local ethics committee. Thirteen beagles were included with ECV quantified by CCT and CMR at baseline, 16 and 24 weeks after modeling. Spearman correlation analysis was used to determine the association between CT ECV, CMR ECV, collagen volume fraction (CVF), LVEF and serum fibrosis index (Hyaluronic acid [HA], Laminin [LN] and Type-III procollagen [PCIII]). RESULTS: Median ECV values in CT and CMR at 16 and 24 weeks were significantly higher than those at baseline (CT ECV: 34.4% and 37.7% vs. 25.2%; CMR ECV: 32.2% and 37.4% vs. 22.7%; P < 0.001). A strong correlation was found between CCT and CMR for ECV (r = 0.899, P < 0.001). Both correlated well with CVF (r = 0.951 and 0.879 for CT and MR ECV vs. CVF, P < 0.001), serum fibrosis index (r = 0.830-0.907 for CT and MR ECV vs. HA, LN, PCIII, respectively, P < 0.05) and were inversely related to LVEF (r = -0.846 and -0.804 for CCT and CMR, P < 0.001). Bland-Altman analysis showed a small bias (1.5%), with 95% limits of agreement of -2.7% and 5.6%. CONCLUSIONS: CCT-derived ECV correlates well with CMR, histology and serum fibrosis index, suggesting that CCT is capable of myocardial tissue characterization.