{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:40:05Z","timestamp":1756370405856,"version":"3.44.0"},"reference-count":23,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,3,29]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>The ampulla portion of the fallopian tube is the most common site of ectopic pregnancy (70%), with approximately 2% of pregnancies implanted in the interstitial portion. In general, an interstitial ectopic pregnancy (IEP) is difficult to diagnose and is associated with a high rate of complications\u2014most patients with an IEP present with severe abdominal pain and haemorrhagic shock due to an ectopic rupture. Chronic tubal pregnancy (CTP) is an uncommon condition with an incidence of 20%. The CTP has a longer clinical course and a negative or low level of serum beta-human chorionic gonadotropin due to perished chorionic villi. This study presents a case of a woman who was diagnosed with a chronic IEP (CIEP) which was successfully treated by surgery. This case also acts as a cautionary reminder of considering a CIEP in women of reproductive age presenting with amenorrhea, vaginal bleeding and a negative pregnancy test.<\/jats:p>","DOI":"10.1136\/bcr-2023-259267","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T13:30:37Z","timestamp":1712583037000},"page":"e259267","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic interstitial ectopic pregnancy presenting with a negative urine pregnancy test"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7688-0740","authenticated-orcid":false,"given":"Apiwat","family":"Jongjakapun","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6101-5589","authenticated-orcid":false,"given":"Lingling","family":"Salang","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2648-0383","authenticated-orcid":false,"given":"Apiwat","family":"Aueaungkul","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7288-9617","authenticated-orcid":false,"given":"Pilaiwan","family":"Kleebkaow","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,4,8]]},"reference":[{"key":"2025082801251486000_17.4.e259267.1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.12.3224"},{"key":"2025082801251486000_17.4.e259267.2","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000109218.24211.79"},{"key":"2025082801251486000_17.4.e259267.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.07.054"},{"key":"2025082801251486000_17.4.e259267.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(99)00242-3"},{"key":"2025082801251486000_17.4.e259267.5","unstructured":"Handa VL , Van Le L . Te Linde\u2019s Operative Gynecology Twelfth edition. Philadelphia: Wolters Kluwer, 2020."},{"key":"2025082801251486000_17.4.e259267.6","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1007\/s00404-019-05240-7","article-title":"Chronic ectopic pregnancy: case report and systematic review of the literature","volume":"300","author":"Tempfer","year":"2019","journal-title":"Arch Gynecol Obstet"},{"key":"2025082801251486000_17.4.e259267.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.1996.tb03283.x"},{"key":"2025082801251486000_17.4.e259267.8","doi-asserted-by":"publisher","DOI":"10.1016\/0301-2115(96)02443-8"},{"key":"2025082801251486000_17.4.e259267.9","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2021-245742","article-title":"Ruptured chronic ectopic pregnancy presenting with a negative urine pregnancy test","volume":"15","author":"Dunphy","year":"2022","journal-title":"BMJ Case Rep"},{"key":"2025082801251486000_17.4.e259267.10","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2022-253396","article-title":"Chronic ectopic pregnancy presenting as a suspected Tubo-ovarian abscess: a diagnostic dilemma","volume":"16","author":"Alao","year":"2023","journal-title":"BMJ Case Rep"},{"key":"2025082801251486000_17.4.e259267.11","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-233534","article-title":"Chronic ectopic pregnancy mimicking pelvic malignancy","volume":"14","author":"Omih","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025082801251486000_17.4.e259267.12","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1368589"},{"key":"2025082801251486000_17.4.e259267.13","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2020-237053","article-title":"Case of a chronic ectopic pregnancy Misdiagnosed as pelvic inflammatory disease","volume":"14","author":"Sekar","year":"2021","journal-title":"BMJ Case Rep"},{"key":"2025082801251486000_17.4.e259267.14","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/903848","article-title":"Neurobiological mechanisms of pelvic pain","volume":"2014","author":"Origoni","year":"2014","journal-title":"Biomed Res Int"},{"key":"2025082801251486000_17.4.e259267.15","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1001\/jama.2013.3914","article-title":"Does this woman have an ectopic pregnancy?: the rational clinical examination systematic review","volume":"309","author":"Crochet","year":"2013","journal-title":"JAMA"},{"key":"2025082801251486000_17.4.e259267.16","first-page":"1044","article-title":"Sonographic evolution of Cornual pregnancies treated without surgery","volume":"79","author":"Timor-Tritsch","year":"1992","journal-title":"Obstet Gynecol"},{"key":"2025082801251486000_17.4.e259267.17","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":"2025082801251486000_17.4.e259267.18","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.clinimag.2014.04.002","article-title":"Cornual, interstitial, and angular pregnancies: clarifying the terms and a review of the literature","volume":"38","author":"Arleo","year":"2014","journal-title":"Clin Imaging"},{"key":"2025082801251486000_17.4.e259267.19","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s00404-006-0211-6","article-title":"Three-dimensional Transvaginal Sonographic diagnosis of early and asymptomatic interstitial pregnancy","volume":"275","author":"Araujo J\u00fanior","year":"2007","journal-title":"Arch Gynecol Obstet"},{"key":"2025082801251486000_17.4.e259267.20","doi-asserted-by":"publisher","DOI":"10.1148\/rg.325115153"},{"key":"2025082801251486000_17.4.e259267.21","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s00404-016-4069-y","article-title":"Non-Tubal ectopic pregnancy","volume":"294","author":"Parker","year":"2016","journal-title":"Arch Gynecol Obstet"},{"key":"2025082801251486000_17.4.e259267.22","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14189"},{"key":"2025082801251486000_17.4.e259267.23","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/0020-7292(95)80018-2","article-title":"Chronic ectopic pregnancy after clinically successful methotrexate treatment of ectopic pregnancy","volume":"51","author":"Dunn","year":"1995","journal-title":"International Journal of Gynecology & Obstetrics"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-259267","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:25:24Z","timestamp":1756369524000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-259267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":23,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,8]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/bcr-2023-259267"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-259267","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}