An unusual case of pain in the right upper quadrant

Submitted by : Ali Alsafi, Chris Harvey, Imperial College Healthcare NHS Trust, London

Presentation:

A 37 year-old lady with a three month history of pain in the right upper quadrant was referred by her GP for an abdominal ultrasound. She also had a long history of pelvic pain.

Ultrasound images are shown in Figs 1, 2 and 3.

	Figure 1 Sagittal view of the liver. The site of pain (arrows) was indicated by the patient.
	Figure 2 Cineclip of the area indicated in Fig 1 using a high frequency probe with power Doppler.
	Figure 3 Ultrasound of the left ovary (arrow).

What is the most likely diagnosis and differential diagnoses?

To see the diagnosis / differential diagnoses please click here