Appendicitis , right ovarian cyst

Images Genevieve Carbonatto  

A 34 year old woman  presents to the Emergency Department  with a 3 day history of right iliac fossa pain. An outpatient pelvic ultrasound showed a right ovarian cyst with some  fluid in the pouch of Douglas. The ruptured ovarian cyst was thought to be the cause of her pain. A point of care ultrasound  shows that the maximum  point of tenderness is over an inflamed appendix.

Ovarian cyst 3.69 cm. Longitudinal view through pelvis. Fluid in pouch of Douglas. Transverse view of pelvis. Uterus visible, fluid in pouch of Douglas deep to bladder and around uterus. Right ovarian cyst

Tranverse view of the appendix (2.7cm) .Longitudinal view of thickened appendix

 

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