Q. A 24-year-old female is admitted with complaints of lower abdominal pain, fever, and vaginal discharge. She reports experiencing these symptoms for the past week and notes that they have progressively worsened over time. The patient also reports a history of unprotected sexual intercourse with multiple partners over the past several months. On physical examination, she is found to have a tender abdomen with significant lower abdominal tenderness. Her pelvic examination reveals cervical motion tenderness and purulent cervical discharge. Given these findings, you make a presumptive diagnosis of pelvic inflammatory disease (PID). Laboratory studies are obtained and reveal an elevated white blood cell count and an elevated erythrocyte sedimentation rate. Additionally, a pelvic ultrasound is performed, which shows evidence of bilateral tubal dilation. The patient is started on intravenous antibiotics. Which of the following associated conditions is this patient at the greatest risk of developing?