18 y.o. woman complains of pain in the lower abdomen. Some minutes before she has suddenly appeared unconscious at home. The patient had no menses within last 3 months. On examination: pale skin, the pulse- 110 bpm, BP- 80/60 mm Hg. The Schyotkin's sign is positive. Hb- 76 g/L. The vaginal examination: the uterus is a little bit enlarged, its displacement is painful. There is also any lateral swelling of indistinct size. The posterior fornix of the vagina is tendern and overhangs inside. What is the most probable diagnosis?

Answer options

1. Impaired extrauterine pregnancy
2. Twist of cystoma of right uterine adnexa
3. Acute salpingoophoritis
4. Ovarian apoplexy
5. Acute appendicitis

Explanation

18 y.o. woman complains of pain in the lower abdomen. Some minutes before she has suddenly appeared unconscious at home. The patient had no menses within last 3 months. On examination: pale skin, the pulse- 110 bpm, BP- 80/60 mm Hg. The Schyotkin’s sign is positive. Hb- 76 g/L. The vaginal examination: the uterus is a little bit enlarged, its displacement is painful. There is also any lateral swelling of indistinct size. The posterior fornix of the vagina is tender and overhangs inside. What is the most probable diagnosis? Blumberg’s sign (also referred to as rebound tenderness, Shyotkin-Blumberg sign) is a clinical sign that is elicited during the physical examination of a patient’s abdomen by a doctor or other health care provider. It is indicative of peritonitis.