There is a bilobed fat containing heterogeneous mass in the pelvis posterior to the uterus, with amorphous calcific foci within it. Within its lower moiety a tooth is simulated. The appearances are consistent with a mature cystic teratoma. Minimal free fluid is demonstrated in the pouch of Douglas.
Furthermore, there is intraperitoneal fat density material similar to that within the pelvic tumour, insinuating in the pelvis, overlying the urinary bladder, extending cephalad over the right iliac fossa reaching the hepatorenal recess and forming a shallow accumulation of the surface of the right liver. The appearances are concerning for intraperitoneal rupture of the cystic teratoma.
The appendix is mildly distended, and there is minimal periappendiceal fat stranding and free fluid. An appendicolith is identified at the appendix ostium. There are a few enlarged lymph nodes in right iliac fossa. All these findings are suggestive of acute appendicitis.