title: MDCT diagnosis of ruptured tubal pregnancy with massive hemoperitoneum.
abstract: 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.
authors.affiliation: Department of Diagnostic Radiology, Clinique St Luc, Rue St Luc 8, 5004 Bouge (Namur), Belgium. bcoulier@skynet.be
authors.forename: Bruno
authors.initials: B
authors.lastname: Coulier
authors.forename: Stéphane
authors.initials: S
authors.lastname: Malbecq
authors.forename: Pierre-Etienne
authors.initials: PE
authors.lastname: Brinon
authors.forename: Adrien
authors.initials: A
authors.lastname: Ramboux
mesh_terms: D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006465:Hemoperitoneum / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000000981:diagnostic imaging* / Q000601:surgery; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media