A 19-year-old woman presented to the emergency department with periodic lower abdominal and pelvic pain. She informed that she had been experiencing the pain over the past seven years. The patient did not experience fever, chills or dysuria. Additionally, she informed that she had not had any vaginal intercourse, and also informed of not having menses.
A physical examination revealed distension in the lower abdomen and a firm and tender suprapubic mass that extended from the pelvis to the umbilicus. A perineal exam was conducted; the results can be seen in the cover image. Source – The New England Journal of Medicine *This image challenge is from the editorial team of Docplexus, and is meant for educative purposes only. The correct answer can be seen here !
