Acute Pelvic Pain Presentations

Question 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

Answer 1

Ectopic Pregnancy

Question 2

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

Answer 2

Urinary Tract Infection

Question 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

Answer 3

Appendicitis

Question 4

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

Answer 4

Pelvic Inflammatory Disease

Question 5

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

Answer 5

Ovarian Torsion

Question 6

Vaginal bleeding and crampy lower abdominal pain following a period of amenorrhoea (absence of menstruation)

Answer 6

Miscarriage