Gynacology Emergency

Question 1

Ovarian torsion

Answer 1

Sudden onset unilateral pelvic pain
Can be bilateral
May have palpable mass
Ix - Straight to imaging
Tx - Rule out DDX (ectopic, PID, degenerating fibrosis, endometriosis)
- Laparoscopy may need to remove stuff otherwise just pin it down.

Question 2

Ectopic

Answer 2

TV USS greater then 1500 B HCG with gestational sac
Mx
- Methotrexate if no rupture and B HCG less then 5000, stable haemodyamonic, less then 3-4cm, F/U
- Surgery. Salpingotomy, salpingectomy,