In ectopic pregnancy, referred shoulder pain can occur due to what?

In ectopic pregnancy, referred shoulder pain can occur due to what?

• A. Diaphragmatic irritation
• B. Nerve compression
• C. Electrolyte imbalance
• D. Dehydration

Answer: (A)

Referred shoulder pain in this context comes from irritation of the diaphragmatic peritoneum by blood in the abdominal cavity after rupture. The diaphragmatic surface is innervated by the phrenic nerve (C3–C5), so irritation sends pain signals that are felt in the shoulder region, often called Kehr sign. This mechanism explains why the shoulder area, not the abdomen, becomes painful. Nerve compression, electrolyte imbalance, or dehydration don’t produce this diaphragmatic referral pattern.

Referred shoulder pain in this context comes from irritation of the diaphragmatic peritoneum by blood in the abdominal cavity after rupture. The diaphragmatic surface is innervated by the phrenic nerve (C3–C5), so irritation sends pain signals that are felt in the shoulder region, often called Kehr sign. This mechanism explains why the shoulder area, not the abdomen, becomes painful. Nerve compression, electrolyte imbalance, or dehydration don’t produce this diaphragmatic referral pattern.