by Tsaousis B.E
A 20s-year-old female with no significant past medical history presents with pelvic pain for 1 day associated with nausea. Her last menstrual period began 10 days ago. Vital signs on arrival include HR 126 bpm and BP 130/96. Her abdomen is mildly tender in the right lower quadrant. Transabdominal POCUS (clips below) shows free fluid in the pelvis and right upper quadrant (hepatorenal space) and no intrauterine pregnancy. A urine pregnancy test is positive. The patient is immediately taken to the OR. She undergoes a laparoscopic salpingectomy of a tubal ectopic pregnancy and evacuation of hemoperitoneum. She recovers well and is discharged home later the same day.
POCUS can rapidly risk stratify reproductive-age female patients to identify those whose condition is of greatest concern and, in conjunction with urine pregnancy tests, can ensure timely recognition of this life-threatening condition even before the patient leaves the resus bay.
Free fluid at the caudal edge of the liver.
Pelvic free fluid and no obvious intrauterine pregnancy.