Acute Pelvic Pain in Women : triage

Acute pelvic pain in women represents a common yet complex clinical challenge, encompassing a broad spectrum of possible gynecologic and non-gynecologic causes. For non-pregnant women, frequent gynecological sources include pelvic inflammatory disease (PID), ruptured ovarian cysts, ovarian torsion, and the degeneration or torsion of uterine leiomyomas. In contrast, pregnant patients more commonly experience acute pelvic pain due to spontaneous abortion, ectopic pregnancy, and placental disorders.

The diagnosis of pelvic pain requires a meticulous and systematic approach, prioritizing the exclusion of urgent life-threatening and fertility-threatening conditions. A thorough history that captures the pain's characteristics, coupled with a comprehensive review of systems and detailed gynecologic, sexual, and social history, is foundational. Physical examination further refines the differential diagnosis. While PID, ruptured ovarian cysts, and appendicitis are among the most urgent causes of pelvic pain, a variety of other conditions can mimic these presentations, often necessitating the use of diagnostic imaging to clarify the cause.

Data Gathering for Acute Pelvic Pain in Women