Clip 1: Free fluid seen at caudal edge of the liver
Clip 2: Empty uterus with pelvic free fluid and right sided ectopic pregnancy.
30s F presents with mild right lower quadrant abdominal discomfort. Vital signs: normotensive, not tachycardic. Time and time again, like this crew, you just have to look at the hepatorenal space for free fluid. There’s nothing on physical exam or history of present illness that takes it off the table.
The Evidence: Free fluid predicts the need for operative management in ectopic pregnancy (Moore et al, 2008), vital signs don’t correlate with hemoperitoneum (Hick et al, 2001), and the most sensitive place to look for hemoperitoneum is the caudal edge of the liver (Lobo et al, 2017).