Sonography of ectopic pregnancy

this patient was a young woman with a history of five weeks amenorrhoea. She also gave a history of bleeding PV, a few days before the ultrasound scan. Transabdominal and transvaginal sonography was done. Some of the Ultrasound images are shown below:
Transabdominal ultrasound images of this case show a bulky uterus with possible left adnexal mass.
 There is also a suggestion of a small amount of fluid in the cul-de-sac.

Colour Doppler ultrasound shows mild vascularity around the left adnexal region- nothing significant there:

 

But transvaginal ultrasound shows an entirely different picture. The images below show significant fluid in the cul-de-sac and the adnexal regions. the ominous nature of the mass in the left adnexal region is also more obvious. The left adnexal mass measures more than 4 x 2 cm. Though again, colour Doppler shows limited vascularity in this region, the ultrasound and Doppler images together suggest a leaking ectopic pregnancy in the left adnexal region. Final diagnosis: left ectopic (tubal) pregnancy with haemorrhagic fluid in the cul-de-sac.

 Visit: http://www.ultrasound-images.com/early-pregnancy.htm#Right_ectopic_pregnancy