Case 14 - Not too eggstatic
Author: Nish Cherian Reviewer(s): Nick Mani
A 37-year old female presented to the ED with abdominal pain and bloating. She report a few episodes of vomiting and mild shortness of breath. She is currently undergoing IVF. Her vitals are: HR 105, BP 105/60, RR 23, SpO2 93% on RA. Her abdomen is diffusely tender without guarding and appears distended. Blood tests and hCG are pending.
You perform a focused abdominal ultrasound:
Clip 1. RUQ
Clip 2. LUQ
Clip 3. Pelvis long axis - fanning through
Clip 4. Pelvis short axis
Clip 5. Right ovary
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Intraperitoneal free fluid and small left pleural effusion
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Moderate volume pelvic free fluid, no intrauterine pregnancy and a very cystic looking right ovary with loss of normal tissue architecture.
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Ovarian hyperstimulation syndrome
Case resolution
The patient was managed conservatively with analgesia and IV fluids to maintain adequate urine output. Her blood results were relatively unremarkable. She was admitted under the O&G team and made a full recovery.
