Case presentation A primigravid woman at 24 weeks and 6 days of gestation presented to the emergency department with middle to upper abdominal pain persisting for the past 16 hours. She also reported worsening constipation over the previous 4–5 days.
There was no history of trauma or recent coitus. Medical history Previous surgery for left ovarian endometrioma Current pregnancy achieved through assisted reproductive technology History of habitual constipation and poor appetite during pregnancy Regular antenatal follow-ups No abnormalities detected in routine prenatal scans Initial examination Vital signs: Normal Abdominal palpation Irregular uterine contractions Marked tenderness in the upper abdomen without guarding or rebound Pain aggravated by movement and relieved at rest Fundal height: 24 cm Vaginal examination No evidence of pathology, bleeding, or rupture of membranes The cervix…
