What's your diagnosis in this young woman with right pelvic pain and a history of amenorrhea?
Images courtesy of Firoz Bhuvar, MD
Right tubal ectopic pregnancy
There is a rounded, thick-walled complex right adnexal mass (which is the thickened right Fallopian tube containing the ectopic pregnancy) with collection of echogenic fluid in the pouch of Douglas or cul-de-sac suggestive of hemorrhagic fluid. In addition, the uterus does not show the presence of a gestation sac but rather shows evidence of decidual change in the endometrium. All of these findings together point to a diagnosis of ectopic pregnancy in the right fallopian tube.