Clip 1: Free fluid surrounding caudal edge of the liver.
Clip 2: Free fluid surrounding the caudal edge of the liver.
A 30s female arrives to the emergency department complaining of pretty bad left lower quadrant pain. It started acutely 2 hours prior to arrival. and she recently found out she was pregnant. She feels lightheaded, but hasn’t passed out. BP 74/57, HR 76, RR 19. POCUS Hepatorenal space shows free fluid. She’s resuscitated with blood products and is emergently taken to the operating room where she is found to have 1.5 liters of hemoperitoneum from a ruptured left sided fallopian tube ectopic pregnancy. 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).