HOWARD1 lists many diseases in which the serum amylase level may be elevated including ruptured tubal pregnancy.
A search of the literature disclosed a single case report2 of ruptured ectopic pregnancy with elevated serum amylase levels. It is that of a woman, aged 22 years, with acute abdominal pain, abdominal tenderness and rigidity, and a serum amylase level of 1,600 Somogyi units (normal is less than 200 units). A laparotomy was performed and a ruptured tubal pregnancy removed. The pancreas, gallbladder, and liver were normal. The next day the serum amylase was 1,680 units; 14 days later, 360 units; one year later, 300 units; and two years later, 110 units. Cholecystogram, glucose tolerance test, and mumps complement fixation test were normal.
We recently treated a similar case and think it worthwhile reporting, for the abnormal levels of serum amylase led to delay in making the correct diagnosis.