hi i am a nurse who worked in the OPD in one of the remote hospital in the Solomon. as i attend to our general out patient today a 30 yrs old female was came in with the history of pain to her abdomen esp to her rt illiac fossa and the umbilical region pt describe pain as constant. the above complaints onset a week ago no fever associated. no vomiting no diarrhoea, no dysuria no PV bleeding or discharges. her LMP was on oct 2013. O/E: she was orientated not in distress and responding well to every single question given to her. abdomen slightly distended to umbilical region and rt illiac fossa. on palpation abd, soft a mass like felt on the umbilical region to rt illiac area pain on deep palpation no guarding on palpation. vitals Temp: 36 degree celcius pulse 80bpm resp: 20rpm b/p:120/70mmHg RBSL: 6mmol/l scan was unable to perform plus blood test. i hope you have some fair ideas of the problem please if could help us while our is away to help our patient. thank you for your help chris.