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29 y/o woman, nausea, vomiting and abdominal pain

Presentation

A 29-year-old woman presented to the emergency room with nausea, vomiting and abdominal pain. The pain was initially in the periumbilical area and later localized to the right lower quadrant. On physical exam, her temperature was 38 degrees Celsius. She had guarding and mild rebound tenderness in the right lower quadrant of her abdomen. On pelvic examination, there is right adnexal tenderness. Her white blood cell count (WBC) is 12K/µl and her urine B-HCG is negative.

Images

Supine and upright radiographs of the abdomen
Ultrasound

Description of Findings

Full case report

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