This patient presented with lower abdominal pain and a suboptimal rise in her BHCG.
The ultrasound showed:
- an empty uterus,
- a small amount of free fluid with echogenic particulate matter suspended within it
- an echogenic adnexal mass adjacent but separate from the ovary
- the mass showed a "ring of fire" when colour Doppler was applied indicating a rim of highly vascular tissue.
All these findings are consistent with a tubal ectopic pregnancy.
After discussing the various options the patient was taken to theatre for a laparoscopic salpingectomy.