Pelvic pain - Acute

Question 1

Pelvic pain

Acute

Ectopic pregnancy

Answer 1

A typical history is a female with a history of 6-8 weeks amenorrhoea who presents with lower abdominal pain and later develops vaginal bleeding
Shoulder tip pain and cervical excitation may be seen

Question 2

Pelvic pain

Acute

Urinary tract infection

Answer 2

Dysuria and frequency are common but women may experience suprapubic burning secondary to cystitis

Question 3

Pelvic pain

Acute

Appendicitis

Answer 3

• Pain initial in the central abdomen before localising to the right iliac fossa
• Anorexia is common
• Tachycardia, low-grade pyrexia, tenderness in RIF
• Rovsing’s sign: more pain in RIF than LIF when palpating LIF

Question 4

Pelvic pain

Acute

Pelvic inflammatory disease

Answer 4

• Pelvic pain, fever, deep dyspareunia, vaginal discharge, dysuria and menstrual irregularities may occur
• Cervical excitation may be found on examination

Question 5

Pelvic pain

Acute

Ovarian torsion

Answer 5

• Usually sudden onset unilateral lower abdominal pain. Onset may coincide with exercise.
• Nausea and vomiting are common
• Unilateral, tender adnexal mass on examination

Question 6

Pelvic pain

Acute

Miscarraige

Answer 6

Vaginal bleeding and crampy lower abdominal pain following a period of amenorrhoea