{"paper_id":"03b66574-3a1e-4525-a0cd-bc98ccfb7516","body_text":"ECR 2026 / C-22939\nThe role of CT in acute pelvic pain of gynecologic origin in nonpregnant premenopausal women\nCongress:\nECR 2026\nPoster Number:\nC-22939\nType:\nEducational Exhibit\nKeywords:\nEmergency, Genital / Reproductive system female, Pelvis, CT, CT-Angiography, MR, Arterial access, Contrast agent-intravenous, Surgery, Abscess, Acute, Haemorrhage\nAuthors:\nD. I. Miftode, C. Lupascu-Ursulescu\nDOI:\n10.26044/ecr2026/C-22939\nLearning objectives\nTo review the role of CT in the evaluation of acute pelvic pain of gynecologic origin\nTo describe key CT findings in common gynecologic emergencies\nTo emphasize the complementary role of CT to ultrasound in emergency settings\nBackground\nAcute pelvic pain in nonpregnant premenopausal women is a frequent and clinically challenging presentation in emergency settings, encompassing a wide spectrum of gynecologic and non-gynecologic etiologies. Prompt and accurate diagnosis is essential, as several gynecologic conditions may be life-threatening or fertility-threatening if not recognized early.Transvaginal ultrasound is the first-line imaging modality for suspected gynecologic pathology; however, its diagnostic performance may be limited by operator dependency, patient-related factors, and overlapping imaging features in acute presentations. In this context, computed tomography (CT) is increasingly utilized, particularly when...\nFindings and procedure details\nIn non-pregnant reproductive-age women, the main etiologies include ovarian cyst rupture or hemorrhage, pelvic inflammatory disease, ovarian torsion, endometriosis and degeneration or torsion of uterine myomas.Hemorrhagic Ovarian CystsHemorrhagic ovarian cysts are common in premenopausal women and result from bleeding into a functional cyst. Acute pain may occur due to rapid cyst expansion or rupture.CT findings:\nWell-defined adnexal cystic lesion\nHyperattenuating intracystic content reflecting acute blood\nFluid–fluid levels in some cases\nIrregular or thickened cyst wall\nIn cases of rupture, high-attenuation free intraperitoneal fluid consistent with...\nConclusion\nAcute pelvic pain in nonpregnant premenopausal women represents a diagnostic emergency with a wide spectrum of gynecologic etiologies and significant clinical overlap.\nWhile ultrasound remains the first-line modality, CT is a critical second-line tool when initial imaging is inconclusive or when complications are suspected.\nCT provides rapid, comprehensive evaluation of the pelvis and abdomen, enabling confident identification of hemorrhage, ischemia, infection, and rupture across both common and uncommon gynecologic conditions.\nRecognition of key CT imaging patterns allows prompt diagnosis of life-threatening entities such as ovarian...\nPersonal information and conflict of interest\nD. I. Miftode:\nNothing to disclose\nC. Lupascu-Ursulescu:\nNothing to disclose\nReferences\n1. \"Saint Spiridon\" Emergency County Hospital in Iasi, Romania - database.2. https://radiopaedia.org/3. https://radiologyassistant.nl/4. Basta Nikolic M, Spasic A, Hadnadjev Simonji D, Stojanović S, Nikolic O, Nikolic D. Imaging of acute pelvic pain. Br J Radiol. 2021 Nov 1;94(1127):20210281. doi: 10.1259/bjr.20210281. Epub 2021 Sep 7. PMID: 34491817; PMCID: PMC8553212.5. Mahesh Shetty, Acute Pelvic Pain: Role of Imaging in the Diagnosis and Management, Seminars in Ultrasound, CT and MRI, Volume 44, Issue 6, 2023, Pages 491-500, ISSN 0887-2171, https://doi.org/10.1053/j.sult.2023.10.004.6. Franco, P.N.; García-Baizán, A.; Aymerich, M.; Maino, C.;...","source_license":"CC0","license_restricted":false}