We report a case of ruptured tubal pregnancy with massive life-threatening hemoperitoneum. The 38 year-old woman presented with gynaecologic haemorrhage, pelvic pain and hypovolemic shock. Without any ambiguity, the diagnosis was directly made during contrast enhanced Multidetector Computed Tomography (MDCT). Massive hemoperitoneum with fresh blood clots in the hypogastric area, active free peritoneal extravasation of intravascular contrast material and dramatic peripheral enhancement, - "ring of fire" sign - of an adnexal cystic structure were the key signs. These signs must be known by the emergency radiologist because of the more and more use of CT as the first imaging modality in emergency departments particularly for patients with abdominal pain and presenting life-threatening symptoms.
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Article Synopsis
- The study aimed to compare patients with tubal ectopic pregnancy before and during the COVID-19 pandemic in terms of clinical presentation and treatment outcomes.
- During the pandemic, patients reported a higher prevalence of lower abdominal pain, while other clinical indicators like shock index and initial beta-hCG levels remained consistent between the two periods.
- There was a notable shift in treatment approaches; more patients received expectant management, and fewer underwent surgery during the pandemic, along with a reduction in hospital stay duration.
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