Presentation
7 weeks of amenorrhea. Mild pelvic pain.
Patient Data
Uterus: Normal size, normal myometrial echopattern. Empty endometrial cavity
Right ovary: normal follicular pattern.
Left ovary: normal follicular pattern.
Left adnexal thin walled, anechoic cyst ( 10 x 8 mm ) is noted abutting ipsilateral ovary - Paraovarian cyst. Left adnexal thin walled, tubular / ovoid lesion ( 26 x 8 mm ) is noted abutting ipsilateral ovary. There are internal echoes in lesion without vascularity - hematosalpinx.
No adnexal mass lesion is noted on right side.
Minimal free fluid is noted in pelvis.
After US patient developed...
After US patient developed significant pain. 2nd US was done 6 hrs later.
As compared to previous USG about 6 hrs back,
There is increased size of left hematosalpinx - about 46 x 20 mm
There is free fluid in pelvis with internal echoes
Case Discussion
Laparoscopy was done within a few hours. It showed left hematosalpinx, fimbrial miscarriage, hemoperitoneum restricted to pelvis. Tube was intact.
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