A pain in the neck!

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Abstract
A 36-year-old female presented with a 24 h history of constant severe pain in the left side of her neck. On clinical examination there was marked tenderness and swelling within the left anterior triangle of the neck. She had documented polycystic ovarian disease and her two previous pregnancies were induced by Clomiphene and an LHRH pump, respectively. 2 months prior to this presentation she had received 10 000 u of human chorionic gonadotrophin (HCG) and her ovaries were monitored regularly. 3 weeks later she developed abdominal distension, nausea, weight gain, pleural effusion, low blood pressure and a tachycardia. A frontal chest radiograph was taken (Fig. 1). At this stage a clinical diagnosis was made and treatment commenced. 3 weeks later she presented with neck pain and an ultrasound examination was performed (Fig. 2a & b) using 5 MHz linear probe.