31 y/o AAF presents to the ED with complaints of abdominal pain increasing over the past 3 days. She denies N/V/D or F/C. She admits to vaginal discharge and dysuria. She denies vaginal bleeding. LMP 1 month prior?
PMHx: G5P2
PSHx: none
Meds: none
Allergies: NKDA
SocHx: +tob/ETOH/cocaine
PE: BP 110/72, P 75, R 16, POx 100% (RA)
GEN: WNWD, AAF, appears in pain
CHEST: CTA B, nonlabored
CV: RRR, no M/R/G
ABD: diffusely TTP, greatest over suprapubic/pelvic area with guarding and mild rebound, +BS
PEL: cervix thick and closed, erthymatous and friable with copious purulent discharge protruding from the os, +TTP over R adenexa, no masses palpable
WET PREP: sheets of WBCs, no trich, yeast, occasional clue cells
Bedside ultrasound is performed and reveals the following:
Ectopic from UF-Jax Emergency Medicine on Vimeo.
What is the diagnosis?
Thanks to Dr. Kristin McKee for submitting this case!
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