Intrauterine pregnancy confirmed but not interrogated in detail. An inflammatory process is present in the right lower quadrant, extending into the deep pelvis. Air-fluid levels are seen within several pockets within the rectovaginal space. Extending from the caecal pole and inferiorly and medially is an elongated tubular structure with both low and high signal within on SSFSE and gradient echo images, and high signal on the T1 water-only images. This may indicate blood. The right ovary lies anterior to this.
The appearances are highly concerning for a luminal perforation, most likely from a grossly enlarged and inflamed appendix, although it is not clear why there would be blood in this region.