66. Acute abdomen of gynecological origin. Diagnosis, differential diagnosis and treatment.

Question 1

what are all the gynecological causes of acute abdomen

Answer 1

ovary
rupture of cysts
torsion of cysts
mittelschmerz

fallopian tubes
torsion
salpingitis
ectopic pregnancy

uterus 
degeneration of lieyomyomas 
torsion of fibroid 
endometritis 
miscarriage

Question 2

what are the non gynecological causes of acute abdomen ?

Answer 2

appendicitis 
acute cystitis 
diverticulitis 
urinary tract stones 
peritonitis

Question 3

how do we diagnose ruptured ovarian cyst ?

Answer 3

rule out other causes

ultrasound - ectopic pregnancy

blood test - anemia and infection

urine test - other possible causes of pain

vaginal culture - for PID

a transvaginal ultrasound to view the ovaries , fallopian tube and blood flow
laparoscopy can give good diagnosis

Question 4

how do we diagnose torsion of ovaries ?

Answer 4

same as ruptured ovaries

Question 5

what is mittelschmerz

Answer 5

midcycle pain vulanion pain

Question 6

what are the causes of mittelschmerz

Answer 6

follicular swelling

ovarian wall rupture - time of ovulation egg breaks through ovarian wall

fallopian tube contraction after ovulation

smooth muscle cell contraction in the ovary as well as its ligaments

irritation - at time of ovulation blood or other fluid released from ruptured follicle

Question 7

fallopian tube torsion diagnosis ?

Answer 7

rule out others -
hysterosalpingography or
laparoscopy

Question 8

how to diagnose salpingitis ?

Answer 8

abdominal palpation –localised tenderness

pelvic examination -

blood test - leukocytosis

cervicovaginal swab

ultrasound to rule out other causes

laparoscopy

Question 9

diagnosis of degeneration of lieyomyomas (fibroids)

Answer 9

pelvic examination - identify large degenerating fibroids

gynecological ultrasound

hysterosonography

and hysterosalpingography

Question 10

diagnosis of endometritis

Answer 10

US
hysteroscopy
endometrial cytology
endometrial biopsy