Acute Pelvic Pain

Question 1

Ovarian cyst torsion

Answer 1

Sudden onset, severe, colicky pain (+- prev intermittent pain)
Delay can -> irreversible ischaemia
Urgent laparoscopy: cystectomy (oophorectomy if isch/necr)

Question 2

Acute PID

Answer 2

Pyrexial, vomiting, anorexia, malaise
Pelvic pain, pain, discharge, dyspareunia, post coital
Abdo tenderness, cervical excitation
Hx unprotected sex, prev STI, IUD insertion
Most common in 15-25
Pathogens: chlamydia 50%, gonorrhoea 14%, bv, anaerobes

Question 3

Ectopic pregnancy

Answer 3

Woman of childbearing age: +ve BHCG
Amenorrhoea, lower abdo pain, abnormal vaginal bleeding
Dizziness, fainting, shoulder tip pain, collapse
Exam: abdo tenderness, cervical excitation, tender adnexae, adnexal mass