Thursday, August 23, 2012

Fibroid complicating a possible ectopic gestation

This young lady has bleeding P/V with a history of  6 weeks amenorrhoea. Ultrasound images are shown below- the top few images being transabdominal ultrasound images, followed by endocavity sonography.
A large mass is seen above the uterine fundus- is it a pedunculated fibroid?

Note the presence of fluid in the cul de sac: see below:

It gets more intriguing as the fluid is echogenic in the transvaginal ultrasound images below suggesting bloody matter in the cul de sac and left adnexal regions. Is there a left adnexal mass within the thickened left Fallopian tube? The mass above the fundus looks like a typical fibroid, possibly pedunculated. The uterine cavity is empty with no sign of a gestation sac. Is the fluid the result of an ectopic in the left fallopian tube or is it due to ruptured hemorrhagic cyst?

Transvaginal color Doppler images of this patient show limited vascularity around and in the left adnexal mass which measures 2 cms. in size:

For more on sonography of ectopic pregnancy visit:

1 comment:

  1. It's amazing what can be seen by an ultrasound! I have a friend who had a fibroid tumor in her uterus and we were able to see where it was at and that it was pressing on her right ovary. I can't imagine what must be going on inside this woman!