Pregnant Abdominal Pain: Naughty By Nature

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This month’s case is a guest post by Dr. Carrie Ng, a 3rd year PEM fellow from Morgan Stanley Children’s Hospital in New York, NY.

 

 

 

 

A 17-year-old obese female comes to the ED complaining of difficulty urinating and abdominal pain since the night before. The pain is constant, and localizes to the suprapubic region and RLQ. Her LMP was about 1 month ago, around the same time she removed her contraceptive vaginal ring. She has no fever, vaginal bleeding, vomiting, diarrhea, or flank pain. She is hemodynamically stable throughout her ED stay. Her abdomen is soft with no rebound, but she does have involuntary guarding and tenderness to palpation of the suprapubic region and RLQ. Her urine pregnancy test is positive. A bedside ultrasound is done to look for an intrauterine pregnancy and the following image is obtained:

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Thank you for playing! Answers and explanations are posted here.

If you want to see YOUR image included in the next Image of the Month, please email interesting stills and/or clips in addition to a small blurb on the patient to Lorraine Ng at  PEMFellows.com@gmail.com.

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Lorraine Ng

Lorraine Ng

Assistant Clinical Professor and the Fellowship Director of the Pediatric Emergency Ultrasound Fellowship at Columbia University Medical Center
Lorraine's academic interests are in emergency ultrasound and medical education. She is the editor for the Ultrasound Image of the Month series for PEMNetwork.
Lorraine Ng
Lorraine Ng

Lorraine Ng

Lorraine's academic interests are in emergency ultrasound and medical education. She is the editor for the Ultrasound Image of the Month series for PEMNetwork.