Pitfall: Painless ruptured ectopic pregnancy

Images Mark Russel, text Genevieve Carbonatto A 35 year old women  presents to the Emergency Department for a review of a possible ectopic pregnancy. She is 7 weeks pregnant by dates. An outpatient scan was performed the day before for painless vaginal bleeding . It did not show an intrauterine gestational sac. A complex left Read more about Pitfall: Painless ruptured ectopic pregnancy[…]

Ectopic pregnancy

Images Sarah Vaughan (Emergency Registrar) Text Genevieve Carbonatto A young 30 year old lady is brought in by ambulance with acute onset severe lower abdominal pain. The first thing you want to exclude is a ruptured ectopic. On arrival she is pale and looks shocked. She says she had a positive pregnancy test 2 days Read more about Ectopic pregnancy[…]

Ruptured right ectopic, 7 weeks

Images by Genevieve Carbonatto   A  small gestational sac is visible in the right adnexa  with a visible yolk sac.  The uterus is empty. There is hyperechoic blood, (clot)  behind the uterus. The uterus is empty. There is hyperechoic blood, (clot) behind the uterus in the Pouch of Douglas. Difficult to differentiate from  uterus because of similar Read more about Ruptured right ectopic, 7 weeks[…]

Unruptured left ectopic 7 weeks

  Images by Genevieve Carbonatto   Colour Doppler demonstrates peritrophoblastic flow, “ring of fire”. Longitudinal view: Empty uterus – no gestational sac in uterus Transverse view: Uterus and unruptured left tubal ectopic pregnancy . Bagel sign of ectopic pregnancy “Ring of fire” associated with peritrophoblastic blood flow of ectopic pregnancy    

Ruptured ectopic 7 weeks

Images by Genevieve Carbonatto    Ectopic gestational sac In the longitudinal plane, the uterus is more easily identified. Posterior to the uterus there is  a mixed echogenic area. It is coagulated blood. To distinguish blood from bowel remember that bowel has peristalsis and moves, while coagulated blood does not. At the start of the clip, an Read more about Ruptured ectopic 7 weeks[…]

Ruptured ectopic 7 weeks

Images by Genevieve Carbonatto    Severe acute lower abdominal pain, 7 weeks pregnant. Gestational sac – tubal ring, right adnexa.    Transabdominal ultrasound shows empty uterus, fluid in POD and in RIF between loops of bowel. Complex adnexal mass with tubal ring on right. Empty uterus, small amount of fluid in POD Fluid between loops of bowel Read more about Ruptured ectopic 7 weeks[…]