Abstract
A 28-year-old nulligravida presented to the emergency department with a two day history of lower abdominal pain. Initially the pain was dull and diffuse, but it had progressed to a sharp sensation in the right lower quadrant. She stated that she was currently menstruating and has a regular 28-day menstrual cycle. However, upon further questioning, her last menstrual period (LMP) was 45 days ago and this period was lighter than usual. Physical examination revealed normal vital signs (HR 86, BP 114/72, RR 19, SpO2 99%, temperature 37.8°C) and tenderness to palpation in the right lower quadrant. Pelvic examination demonstrated right adnexal fullness. She had a remote history of Chlamydia trachomatis infection, but was otherwise healthy. A serum β-hCG was 2400 mIU/mL; therefore, a transvaginal ultrasound was performed (Figure 1). A 28-Year-Old Female with Lower Abdominal Pain
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