29th April 2024

A 32-year-old woman presents to the emergency department with a sudden onset of severe lower abdominal pain.

A 32-year-old woman presents to the emergency department with a sudden onset of severe lower abdominal pain. She mentions she felt light-headed this morning and has experienced some vaginal spotting over the last two days.

On examination, her blood pressure is 90/50 mmHg, and her pulse is 110 bpm. She appears pale and distressed. Abdominal examination reveals significant tenderness in the right lower quadrant, but no rebound tenderness. A pelvic examination shows a normal, closed cervix and tenderness in the right adnexal region.

Which is the most likely diagnosis?