Images by Genevieve Carbonatto
A 7 week pregnant lady presents to the Emergency department with spotting. A scan through the pelvis demonstrates an empty uterus and what looks like a CL cyst or an ectopic tubal pregnancy in the left adnexa. Colour Doppler demonstrates a “ring of fire” of fire appearance. This can be present around a CL cyst or an ectopic pregnancy. The structure is surrounded by quite thick walls which suggests that this is an ectopic with it’s “bagal sign” or peritrophoblastic reaction. There is no fluid in the pouch of Douglas.
This was confirmed as an unruptured ectopic pregnancy on transvaginal ultrasound and the patient was taken to theatre.