Young Woman With Postpartum Chest and Abdominal Pain

A 16-year-old female adolescent presented to the emergency department with several days of pleuritic chest pain, abdominal pain, and fever. The patient was 2 weeks postpartum from an uncomplicated spontaneous vaginal delivery. She was afebrile, with a pulse rate of 122 beats/min and blood pressure of 95/56 mm Hg. Breath sounds were clear and diffuse abdominal tenderness was noted. Laboratory evaluation revealed a WBC count of 46.8×109/L. Bedside ultrasonography demonstrated fluid collections with prominent fibrinous stranding adjacent to the liver (Figure 1, and Video E1 and E2 [available online at http://www.annemergmed.com]) and uterus (Figure 2).

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