A moderate amount of free fluid is seen surrounding the liver and spleen and within the pericolic gutters. Hyperdense fluid is seen within the pelvis, with a mixed density structure at the level of the right adnexa measuring approximately 3.8 x 4.3 x 4.6 cm. Hyperdense material associated with the right adnexal mass is suspicious for extravasation of contrast due to active haemorrhage into an ovarian cyst. The left ovary demonstrates numerous follicles.
No evidence of free gas within the abdomen or pelvis. The appendix is not dilated. A linear hypodensity is seen posteriorly within the spleen.
Normal appearance of the liver, gallbladder, pancreas and adrenal glands. Suspected small cortical cyst in the midpole of the right kidney. No small or large bowel abnormality identified.
The lung bases are clear. Bilateral pars defects within L5, no acute osseous pathology identified.
IMPRESSION
- Findings are in keeping with haemorrhage of a right adnexal lesion, likely an ovarian cyst in the setting of a negative beta-hCG. Further evaluation with ultrasound may be of value.
- Linear hypodensity within the spleen may represent a focal laceration, however the surrounding fluid is more hypodense than in the pelvis and is less likely without a history of trauma. A small cleft would be more likely.