13 - Abdominal and Pelvic Pain in the Nonpregnant Female

Question 1

Imaging modality of choice for genital tract pathology

Answer 1

Ultrasound

Pelvic US is the primary imaging modality for evaluation of lower abdominal pain in the female patient in whom a gynecologic diagnosis is considered most likely

Question 2

Preferred imaging modality for GI or GU pathology

Answer 2

CT

Question 3

Term used for midcycle pain at the time of ovulation caused by NORMAL follicular enlargement prior to ovulation or follicular bleeding at ovulation

Answer 3

Mittelschmerz

Question 4

Peak incidence for dermoid age

Answer 4

10-30 years old

Question 5

Characteristics of ovarian cysts that are concerning or worrisome for neoplasm

Answer 5

1. Large (>8 cm)
2. Solid
3. Multiloculated

Question 6

Mean age of diagnosis for ovarian neoplasm

Answer 6

50-60 years old

Question 7

Remarks for ovarian Hyperstimulation Syndrome

Answer 7

• Complication of ovulation induction treatments
• Ranges from mild abdominal bloating to critical and potentially fatal conditions
• Severe syndrome is characterized by massive transudation of albumin and fluid from the vascular compartment to the peritoneal, pleural and sometimes, pericardial cavities

Question 8

Remarks on ovarian torsion

Answer 8

• Nearly 70% of torsions occur on the RIGHT SIDE, due to the increased length of the utero-ovarian ligament on the right and the sigmoid on the left, limiting space for movement
• patients present as sudden onset of severe, lower abdominal pain that may develop after episodes of exertion

Question 9

Most common ultrasonographic finding associated with torsion

Answer 9

Ovary >4cm in size due to cyst, tumor or edema

Note: THIS IS A LATE FINDING AND SHOULD NOT BE USED AS THE ONLY ULTRASOUND FINDING TO EXCLUDE TORSION