PMC6700323_01
Transvaginal sagittal ultrasound of the uterus demonstrates a small echogenic focus (arrow) within the endometrial canal, which is distended with complex fluid. There is also heterogeneous material in the posterior cul-de-sac, suspicious for blood clot.
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An echogenic rounded focus measuring up to 4 mm was also present within the endometrial canal, without evidence of a yolk sac (Fig. 1).
A and B:Transvaginal axial images of the left adnexal region without and with power Doppler demonstrate a small complex lesion with peripheral vascularity at the medial aspect of the left ovary (OV). There is also heterogeneous avascular material adjacent to the left ovary, concerning for blood clot.
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Within both adnexa and the inferior pelvis, a moderate amount of free fluid was demonstrated, along with heterogeneous avascular material concerning for hemorrhagic material, favored to be clotted (Fig. 2, Fig. 3). No obvious collapsed or ruptured ovarian cyst was identified, although there was a small complex structure at the periphery of the left ovary, query corpus luteum or ectopic (Fig. 2).