The patient describes the pain as sharp, one-sided, and located in the lower abdomen. The pain has been worsening over the past few days and is now associated with some shoulder tip pain. On physical examination, she appears pale and uncomfortable. Her blood pressure is 100/60 mmHg, heart rate is 110 beats per minute, and her abdomen is tender to palpation, especially on the right side.

The patient proceeded to laparoscopy and right salpingectomy. Diagnosis confirmed on pathology.

This is a classic case of a ruptured ectopic pregnancy. It is important for both the sonographer and radiologist to maintain a high index of suspicion when a patient is pregnant and the ultrasound shows no gestational sac in the uterus.