An unusual cause of right iliac fossa painBMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4153 (Published 14 November 2018) Cite this as: BMJ 2018;363:k4153
- Omed Amin, foundation year two doctor,
- David C Howlett, consultant radiologist
- Eastbourne District General Hospital, East Sussex Healthcare NHS Trust, Eastbourne, UK
- Correspondence to O Amin
A 34 year old woman presented to the emergency department with a history of worsening right iliac fossa pain over several days. She described the pain as alternating dull and sharp, and had found simple analgesia (paracetamol, non-steroidal anti-inflammatory drugs) to be ineffective. She had no other associated signs or symptoms and no history other than insertion of an intrauterine contraceptive device (IUCD) several years ago.
A transvaginal ultrasound was unremarkable except that it showed a trace of free fluid in the pelvis, close to the uterus, and the IUCD was not visualised. The patient …