A woman who had had an abortion presented with abdominal pain
A 30 year old woman presented to the emergency department with left sided abdominal pain of two weeks’ duration. Her last menstrual period was eight weeks ago. She previously had a pregnancy terminated six months ago and used a copper intrauterine contraceptive device for contraception. On physical examination she was haemodynamically stable, with tender left iliac fossa and evidence of peritonism. Urine pregnancy test was faintly positive. Blood tests showed 120 g/l haemoglobin with normal white cell count, C reactive protein, urea and electrolytes, creatinine, and liver function. Figure 1 shows the findings of laparoscopy.
(1) What are the laparoscopy findings?
(2) What is the differential diagnosis?
(3) What is the main risk associated with this condition?
(4) How should you manage this patient?
(1) The uterus (UT) and right fallopian tube (F) are visible. Additionally, there is a swelling (X) in the proximal segment of the left fallopian tube.