Review Question - QID 215118

A 23-year-old woman presents to the emergency department with sudden-onset right-sided pelvic pain with nausea and vomiting. The patient was in the middle of intercourse when she acutely felt sharp, lower abdominal pain. When asked about her sexual history, she endorses having multiple partners and only occasionally using condoms. Her temperature is 97°F (36.1°C), blood pressure is 115/75 mmHg, pulse is 105/min, and respirations are 18/min. On the abdominal exam, pain is elicited on palpation of the lower right quadrant. On the bimanual exam, a right adnexal mass is palpated though no vaginal discharge or bleeding is noted. A serum pregnancy test is negative. On ultrasound, no peritoneal fluid is visualized. What is the pathophysiology of this patient’s problem?