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A 38-year-old lady presented to the gynaecologist complaining of a 6-week history of lower abdominal pain, vomiting, constipation, weight loss and vaginal discharge. Her previous medical history included insertion of an intrauterine contraceptive device (IUCD) a year previously and an open appendicectomy. Physical examination revealed a distended abdomen and suprapubic abdominal tenderness with the presence of a palpable firm tender mass arising from the pelvis. Laboratory investigations found normocytic anaemia (haemoglobin 7.3; mean corpuscular volume 80.9 fl), …
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