Evaluation of acute pelvic pain in women
- PMID: 20642266
Evaluation of acute pelvic pain in women
Abstract
Diagnosis of pelvic pain in women can be challenging because many symptoms and signs are insensitive and nonspecific. As the first priority, urgent life-threatening conditions (e.g., ectopic pregnancy, appendicitis, ruptured ovarian cyst) and fertility-threatening conditions (e.g., pelvic inflammatory disease, ovarian torsion) must be considered. A careful history focusing on pain characteristics, review of systems, and gynecologic, sexual, and social history, in addition to physical examination helps narrow the differential diagnosis. The most common urgent causes of pelvic pain are pelvic inflammatory disease, ruptured ovarian cyst, and appendicitis; however, many other diagnoses in the differential may mimic these conditions, and imaging is often needed. Transvaginal ultrasonography should be the initial imaging test because of its sensitivities across most etiologies and its lack of radiation exposure. A high index of suspicion should be maintained for pelvic inflammatory disease when other etiologies are ruled out, because the presentation is variable and the prevalence is high. Multiple studies have shown that 20 to 50 percent of women presenting with pelvic pain have pelvic inflammatory disease. Adolescents and pregnant and postpartum women require unique considerations.
Comment in
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Information from your family doctor. Acute pelvic pain in women.Am Fam Physician. 2010 Jul 15;82(2):148. Am Fam Physician. 2010. PMID: 20642267 No abstract available.
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Sexual violence as a contributor to acute pelvic pain in women.Am Fam Physician. 2011 Feb 15;83(4):352-9; author reply 359. Am Fam Physician. 2011. PMID: 21322509 No abstract available.
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