Pelvic Pain Flashcards
Typical history ectopic pregnancy
- 6-8 weeks amenorrhoea
- lower abdominal pain
- vaginal bleeding
- +/- shoulder tip pain/cervical excitation
Typical history urinary tract infection
- dysuria
- frequency
- +/- suprapubic burning
Appendicitis typical history
- central abdominal pain localising to RIF
- Nausea and vomitting
- low grade fever/tachycardia
- Rosvings sign
- rebound tenderness
What is Rosvings sign
More pain in RIF in when palpating LIF than LIF
Typical history Pelvic inflammatory disease
- pelvic pain
- fever
- Deeps dysparaunia
- vaginal discharge
- dysuria
- menstrual irregularities
- cervical excitation
Typical history ovarian torsion
- Sudden onset severe unilateral pain
- Nausea and vomitting
- unilateral tender adenexal mass
- may have low grade fever
Typical history miscarriage
Vaginal bleeding and crampy lower abdominal pain
floows period of amenorrhoea
Typica history endometriosis
Chornic pelvic pain
dysmenorrhoea - often starts day before bleeding
deep dysparaunia
subfertility
Typical history IBS
- abdo pain - usually associated with defecation
- bloating
- change in bowel habit
- lethargy
- nausea
- backage
Typical history ovarian cyst
- unilaeral dull ache - may be intermittent/with intercoarse
- torsion or rupture may lead to severe pain
- large cysts may cause swellings or pressure effects on the bladder
Typical history urogenital prolapse
Seen in older women
Sensation of pressure, heaviness, ‘bearing-down’
Urinary symptoms: incontinence, frequency, urgency
What is ovarian torsion
- ovary twists and the blood supply is disturbed
- usually secondary to other ovarian pathology, such as a cyst or a tumour.
- Usually occurs in women of reproductive age.
- If the torsion persists, necrosis will occur and there will be a loss of function of that ovary.
What causes ovarian torsions
Occurs when there are ovarian cysts or tumours, that due to their mass cause the ovary to twist on the adnexa.
What is the presentation of ovarian torsion
- known to have ovarian cysts
- Sudden onset severe unilateral lower abdominal pain. This is constant and progressively worsens.
- not always severe, and can take a milder and more prolonged course.
- Nausea and vomiting
- Localised tenderness
- Palpable mass in the pelvis (absence doesn’t exclude the diagnosis)
What are the compliactions of ovarian torsion
- Pain
- Infection
- Rupture (with peritonitis and adhesions)
- Loss of function of that ovary
- The other ovary can compensate and so fertility is not usually affected (only functioning ovary, this will result in infertility and menopause)
