17th August 2020

A 35-year-old woman presents to the emergency department with severe pain in her lower abdomen and vomiting

A 35-year-old woman presents to the emergency department with severe pain in her lower abdomen and vomiting. The pain started about 24 hours ago and is now improving slightly. She has vomited three times since it began. She has had an occasional dull ache in her abdomen, dyspareunia, and irregular vaginal bleeding for a few months now. She is sexually active and takes the combined pill. On examination, there is tenderness over the lower abdomen and a palpable mass in the right iliac fossa. There is nothing visible on vaginal examination and no cervical motion tenderness. Her observations are heart rate 80, respiratory rate 18, BP 120/90, temperature 37.5°C and O2 saturations 97%. Her blood results are normal.

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