Gynaecological Causes of Abdominal Pain Flashcards
What is this a presentation of?
Mid-cycle pain, sharp onset, little systemic upset, recurrent episodes, settles 24-48 hours.
Mittelschmerz
How is Mittelschmerz investigated?
- FBC normal
2. USS may show small quantity of free fluid
What is the management for Mittelschmerz?
Conservative
What is this a presentation of?
Menstrual irregularity, infertility, pain and deep dyspareunia, pelvic adhesions cause recurrent small bowel obstruction.
Endometriosis
How is endometriosis investigated?
- USS may show free fluid
2. Laparoscopy with show lesions
What is the treatment of endometriosis?
- Medical management
2. Surgery if severe
What is this a presentation of?
Sudden onset, deep seated, colicky abdominal pain. Vomiting, distress, adnexal tenderness.
Ovarian torsion
How is ovarian torsion investigated?
- USS shows free fluid
2. Laparoscopy is diagnostic and therapeutic
What is this a presentation of?
Symptoms of pregnancy without evidence of intrauterine gestation, sudden onset abdominal pain, circulatory collapse, adnexal tenderness.
Ectopic gestation
How is ectopic gestation investigated?
- USS shows no intrauterine pregnancy
2. bHCG elevated
What is the treatment of ectopic gestation?
- Laparoscopy/laparotomy if haemodynamically unstable
- Salpingectomy is usually performed
- If stable and meets criteria - medical management with methotrexate
What is this a presentation of?
Bilateral lower abdominal pain, vaginal discharge, dysuria, pre-hepatic inflammation (RUQ pain, fever).
Pelvic inflammatory disease
How is pelvic inflammatory disease investigated?
- High WCC
- Pregnancy test -ve
- High vaginal swabs
What is the treatment for PID?
Medical management
