This 16 year old patient presents to the Emergency Department you have just started at in Menominee Michigan. All of today’s patients have been on their way home this last day of hunting season. You suspect this patient will be more interesting, as she is wearing a PETA shirt and not a shred of orange or leather. Although her chief complaint was nausea and vomiting, her urine pregnancy test was positive, prompting the ultrasound evaluation which revealed this image:
What is your diagnosis and what is the next step for this patient?
7 year old child with abdominal pain presented with pain, nausea. Noted to be febrile. RLQ tender. Linear transducer applied to point of maximal tenderness. 
