The cause of abdominal pain is many a times very difficult and some times very easy to diagnose.If a lady of reproductive age comes for right lower abdominal pain it makes more difficult to arrive at a definitive diagnosis.There are number of diseases which present as right lower abdominal pain and in ladies more conditions add up.But a married lady of reproductive age presenting with missed period ,right lower abdominal pain,severe pallor and shock the most probable diagnosis will come to mind is ruptured ectopic pregnancy in right side.
Ectopic pregnancy is implantation of product of conception in a place other than the normal i.e. uterus.There are several ectopic sites .The most important and common site is tube.Even ectopic pregnancy is seen in women on temporary contraceptive measures like intrauterine devices.This happens because after the fertilization in a part of tube the product does not descend to the normal site i.e. uterus and gets implanted in a part of tube.As the product grows in size, the narrow tube can not accommodate it and bursts towards the end of 8th week to the beginning of 12th week.When this happens it is a medical emergency.There is profound blood loss in abdomen and all other symptoms as described earlier appears.
It confuses among other with most common appendicitis and distinguished by profound pallor.An ultrasonogram clinches the diagnosis.Intervention at a correct time saves the life of patient.