DrVirgo
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27. A 25-year-old nulligravid woman comes to the emergency department because of severe pain in the right lower quadrant of the abdomen for 4 hours. She has had no nausea, vomiting, fever, or chills. Three weeks ago, a right adnexal mass was found on routine examination. Her last menstrual period was 3 days ago. Her temperature is 37.2°C (99°F), blood pressure is 110/70 mm Hg, and pulse is 92/min. Pelvic examination shows right adnexal tenderness. Hemoglobin level is 13 g/dL, and leukocyte count is 9000/mm3. Pelvic ultrasonography shows a small amount of free fluid in the cul-de-sac. Which of the following is the most likely cause of the pain?
O A) Appendicitis
O B) Endometriosis
O C) Ovarian hemorrhage
O D) Ruptured ovarian cyst
O E) Torsion of the adnexa
0 F) Tubal obstruction
D. Ruptured ovarian cyst (there is fluid in the cul de sac)
OR E. Ovarian torsion –(often occurs this acutely with pain)
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| Aashi
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D) Ruptured ovarian cyst
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| DrVirgo
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How can you rule out torsion?
is it because of the fluid in the cul-de-sac?... and a torsion wouldn't have that, correct?
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| hopeofglory87
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I agree Drvirgo
fluid so rupture
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