Gynaecology & Obstetrics

A 31-year-old woman presents to the emergency depament because of two days of abdominal pain without vaginal bleeding. Pelvic examination reveals a closed cervical os and right adnexal pain. The serum beta hCG level is 9,000 mIU/mL. An endovaginal ultrasound demonstrates no intrauterine gestational sac. Which of the following is the most likely diagnosis?