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A 25-Year-Old Woman With Diffuse Abdominal Pain and Shock

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1 A 25-Year-Old Woman With Diffuse Abdominal Pain and Shock
Amen Sergew, MD, Amy L. Olson, MD, Marvin I. Schwarz, MD, FCCP  CHEST  Volume 136, Issue 5, Pages (November 2009) DOI: /chest Copyright © 2009 The American College of Chest Physicians Terms and Conditions

2 Figure 1 Abdominal/pelvic CT scan shows multiple loops of bowel with peritoneal enhancement (black arrow), bowel wall thickening (white arrow), and a large amount of ascites. There was also bilateral hydrosalpinx/pyosalpinx, which was greater on the left than the right (dashed arrow). CHEST  , DOI: ( /chest ) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

3 Figure 2 Abdominal ultrasound showing multiple areas of thick irregular septations in the ascitic fluid suggestive of loculation. The color Doppler ultrasound shows hyperemia in the areas of inflamed tissue. The ascitic fluid is minimally echoic with mild internal echoes, which is more suggestive of simple fluid than thick pus. CHEST  , DOI: ( /chest ) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

4 Figure 3 Peritoneal tissue showing two well-formed nonnecrotizing granulomas. The black arrow indicates a giant cell (hematoxylin-eosin, original ×10). CHEST  , DOI: ( /chest ) Copyright © 2009 The American College of Chest Physicians Terms and Conditions


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