Pelvic pain Flashcards
What is Rovsing’s sign?What condition is it seen in?
when palpation of the left iliac fossa causes increased tenderness in the right iliac fossa
can be seen in appendicitis
What is the whirl pool sign?
This refers to ovarian torsion in gynaecologist, but may also be seen when the bowel twists on itself causing volvulus
What features are found on US w ovarian torsion?
enlarged ovary in the midline w free pelvic fluid (+whirl pool sign)
What is the most common cause of pelvic pain in women?
primary dysmenorrhoea
what is mittelschmerz?
transient pain the middle of the cycle secondary to ovulation
What are the main cause s of acute pelvic pain?
ectopic UTI Appendicitis PID Ovarian torsion Miscarriage
What are causes of chronic pelvic pain?
endometriosis
iBS
Ovarian cyst
urogenital prolapse
Give a brief summary of a typical ectopic pregnancy hx
6-8 weeks amenorrhoea lower abdomen pain vaginal bleeding shoulder tip pain cervical excitation
Give a brief summary of a typical UTI hx
Dysuria
frequnecy
suprapubic burning secondary to cystitis
Give a brief summary of a typical appendicitis hx
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
Give a brief summary of a typical PID hx
Pelvic pain fever deep dyspareunia, vaginal discharge dysuria and menstrual irregularities may occur Cervical excitation
Give a brief summary of a typical ovarian torsion hx
sudden onset unilateral lower abdomen pain
onset may coincide w exercise
N&V
Unilateral tender adnexal mass
Give a brief summary of typical miscarriage
vaginal bleeding
crampy lower abdomen pain following period of amenorrhoea
Give a brief summary of typical endometriosis hx
Chronic pelvic pain
Dysmenorrhoea - pain often starts days before bleeding
Deep dyspareunia
Subfertility
Give a brief summary of typical IBS hx
abdo pain
bloating
change in bowel habit
lethargy, nausea, backache and bladder sx
