{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T23:03:07Z","timestamp":1769382187391,"version":"3.49.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T00:00:00Z","timestamp":1769299200000},"content-version":"vor","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Interstitial ectopic pregnancies account for 1%\u20133% of ectopic pregnancies and carry a high risk of morbidity due to delayed diagnosis and potential catastrophic haemorrhage. Sonographic identification is challenging and may be further confounded by distorted pelvic anatomy, including adenomyosis, which can present with myometrial cysts or sub-endometrial microcysts that mimic a gestational sac.<\/jats:p>\n                  <jats:p>We describe a 36-year-old woman presenting with early-pregnancy bleeding whose initial ultrasounds suggested a possible intrauterine pregnancy due to adenomyosis-related cystic changes. Serial serum human chorionic gonadotropin (hCG) levels rose sub-optimally, and specialist ultrasound ultimately confirmed a right interstitial ectopic pregnancy. She underwent successful laparoscopic uterine wedge resection and bilateral salpingectomy with the use of intramyometrial vasopressin and tranexamic acid to minimize blood loss. This case highlights the importance of vigilance in pregnancies of unknown location, particularly when adenomyosis distorts sonographic anatomy, and demonstrates the role of minimally invasive techniques and haemostatic adjuncts in reducing morbidity.<\/jats:p>","DOI":"10.1093\/jscr\/rjag003","type":"journal-article","created":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T12:30:50Z","timestamp":1767529850000},"source":"Crossref","is-referenced-by-count":0,"title":["A challenging diagnosis of interstitial ectopic pregnancy confounded by sonographic signs of adenomyosis: a case report"],"prefix":"10.1093","volume":"2026","author":[{"given":"Grace","family":"Sutherland","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Northern Beaches Hospital \u2013 Obstetrics and Gynaecology , 105 Frenchs Forest Rd, Frenchs Forest, NSW 2086 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Putt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Northern Beaches Hospital \u2013 Obstetrics and Gynaecology , 105 Frenchs Forest Rd, Frenchs Forest, NSW 2086 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kapilesh","family":"Balachandar","sequence":"additional","affiliation":[{"name":"Northern Beaches Hospital \u2013 Beaches Advanced Gynaecological Surgery , 105 Frenchs Forest Road, Frenchs Forest NSW 2086 ,","place":["Australia"]},{"name":"School of Medicine, Anderson Stuart Building, The University of Sydney , Camperdown NSW 2050 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Ruff","sequence":"additional","affiliation":[{"name":"Northern Beaches Hospital \u2013 Beaches Advanced Gynaecological Surgery , 105 Frenchs Forest Road, Frenchs Forest NSW 2086 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sashi","family":"Siva","sequence":"additional","affiliation":[{"name":"Sydney Ultrasound for Women, Northern Beaches Hospital , Suite 5, Level 6, 105 Frenchs Forest Rd, Frenchs Forest NSW 2086 ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,25]]},"reference":[{"key":"2026012510054183300_ref1","volume-title":"Ectopic pregnancy","author":"BMJ Best Practice","year":"2024"},{"key":"2026012510054183300_ref2","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1186\/s12884-015-0613-1","article-title":"Risk factors for ectopic pregnancy: a multi-center case\u2013control study","volume":"15","author":"Li","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"2026012510054183300_ref3","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1093\/aje\/kwf190","article-title":"Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case\u2013control, population-based study in France","volume":"157","author":"Bouyer","year":"2003","journal-title":"Am J Epidemiol"},{"key":"2026012510054183300_ref4","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s10397-018-1054-4","article-title":"The diagnosis and management of interstitial ectopic pregnancies: a review","volume":"16","author":"Brincat","year":"2019","journal-title":"Gynecol Surg"},{"key":"2026012510054183300_ref5","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1148\/radiology.189.1.8372223","article-title":"Interstitial line: sonographic finding in interstitial (cornual) ectopic pregnancy","volume":"189","author":"Ackerman","year":"1993","journal-title":"Radiology."},{"key":"2026012510054183300_ref6","article-title":"Ultrasonography of pregnancy of unknown location","author":"Mehta","year":"2024","journal-title":"UpToDate"},{"key":"2026012510054183300_ref7","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1002\/uog.24786","article-title":"Consensus on revised definitions of morphological uterus sonographic assessment (MUSA) features of adenomyosis: results of modified Delphi procedure","volume":"60","author":"Harmsen","year":"2022","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2026012510054183300_ref8","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1002\/uog.26197","article-title":"Accuracy of ultrasound signs on two-dimensional transvaginal ultrasound in prediction of adenomyosis: prospective multicenter study","volume":"62","author":"Krentel","year":"2023","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2026012510054183300_ref9","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1002\/uog.26159","article-title":"Prevalence of adenomyosis in women with subfertility: systematic review and meta-analysis","volume":"62","author":"Mishra","year":"2023","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2026012510054183300_ref10","doi-asserted-by":"crossref","first-page":"2289","DOI":"10.1002\/jum.15635","article-title":"Diagnostic accuracy of transvaginal ultrasound and magnetic resonance imaging for adenomyosis: systematic review and meta-analysis and review of sonographic diagnostic criteria","volume":"40","author":"Liu","year":"2021","journal-title":"J Ultrasound Med"},{"key":"2026012510054183300_ref11","first-page":"299","article-title":"A systematic review and meta-analysis of laparotomy compared with laparoscopic management of interstitial pregnancy","volume":"12","author":"Marchand","year":"2021","journal-title":"Facts Views Vis Obgyn"},{"key":"2026012510054183300_ref13","article-title":"Tubal ectopic pregnancy: surgical treatment","author":"Tulandi","year":"2024","journal-title":"UpToDate"},{"key":"2026012510054183300_ref14","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1002\/uog.23319","article-title":"VP59.36: place of vasopressin in demarcation of interstitial ectopic pregnancy during laparoscopic resection: scientific review of a case series","volume":"56","author":"Samarawickrama","year":"2020","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2026012510054183300_ref15","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.ajog.2023.04.047","article-title":"Vasopressin injection purse-string ectopic resection technique for laparoscopic management of cornual ectopic pregnancy","volume":"229","author":"Min","year":"2023","journal-title":"Am J Obstet Gynecol"}],"container-title":["Journal of Surgical Case 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