1st April 2022

A 23-year-old woman presents to the emergency department with severe suprapubic pain

A 23-year-old woman presents to the emergency department with severe suprapubic pain and irregular vaginal bleeding. She is systemically well and has no change in her bowel or urinary habits. She has had a regular male sexual partner for 2 years. Although they do not use condoms, she is confident she is not pregnant as she has had a levonorgestrel-releasing intrauterine system (Mirena®) for the last 2 years. 

A urine pregnancy test comes back positive. 

Which of the following is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.