Ruptured ectopic pregnancy with sentinel clot sign

Discussion:

This case was operated shortly after the scan. Per operatively a ruptured right ovarian ectopic was found.

It was not clinically suspected as the patient's history was non-committal.

The sentinel clot helped localize the source and aided the operative management. In absence of this sign, an exploratory laparotomy would have been done which is time consuming.

The sentinel clot sign is usually seen in the setting of trauma and aids to detect the site of possible bleeding, however it can be used in any acute condition with hemoperitoneum.

Further, this case emphasizes that an ectopic pregnancy should be kept in mind in any female patient of child bearing age.  It has also been reported up to 3 years after hysterectomy.

The sentinel clot sign has also been used by forensic radiologists in post mortem CT scans.

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