Presentation
The patient presented to Emergency Department with mild vaginal bleeding and cramping lower abdominal pain. Quantitative HCG test was performed, and came back positive.
Patient Data
There is no sonographic evidence of intrauterine gestation. However, there are findings of an echogenic mass, inseparable from the left fallopian tube, but separate from the left ovary; this mass shows peripheral vascularity and contains a small cystic structure (might represent a yolk sac).
There is a moderate amount of pelvic complex-free fluid with echogenic material likely representing haemorrhagic fluid with blood products.
These findings highly suggest ruptured left adnexal ectopic pregnancy.
Case Discussion
The constellation of the patient's symptoms, laboratory and sonographic findings suggest a ruptured left adnexal ectopic pregnancy.
The patient was immediately sent to the operating room for laparoscopic left salpingostomy. Laparoscopy revealed bleeding from the fimbriated end of the fallopian tube left adnexal ectopic pregnancy; haemoperitoneum with formed blood clots.
Acknowledgements: I would like to recognise Kallolini S. Tailor, MD and Noori Al-Kadhim, DO, Diagnostic Radiology Department, for assisting in the creation of this case study.
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