Adolescent gynaecology abdominal pain

Question 1

Assessment of lower abdominal pain with NV

Answer 1

Ovarian torsion Urgent gynaecological referral Pelvic ultrasound

Question 2

With amenorrhea, abnormal bleeding

Answer 2

Positive hCG? Consider ectopic pregnancy or threatened Urgent gynae referral + pelvic USS

Question 3

Vaginal discharge +/- fever

Answer 3

Pelvic inflammatory disease Gynae referral Endocervical swabs

Question 4

Recurrent pain

Answer 4

Mid cycle->Mittelsmertz->NSAIDs With menses->dysmenorrhea->NSAIDs No menses->imperforate hymen->Gynae referral and surgery

Question 5

Overview of assessment and management

Answer 5

Menstural history

Obstertric history

Sexual history

Associated symptoms->bladder, bowel, NV

hCG

Always consider GU/GI etiology