Diagnosis of acute pelvic pain

Martin Quan, M Quan
The Journal of family practice · 1992 · vol. 35(4) , pp. 422–32 · PMID:1402731 · W2397898199
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Acute pelvic pain diagnosis in reproductive-age women requires differentiating pregnancy, gynecologic, and nonreproductive causes through history, exam, and testing, with laparoscopy as a gold standard and empiric antibiotics for suspected pelvic inflammatory disease.

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Abstract

The diagnosis of acute pelvic pain in the woman of reproductive age represents a major clinical challenge. In approaching such a patient, the clinician must differentiate between pregnancy-related causes, gynecologic disorders, and nonreproductive tract causes. A careful history and physical examination, along with selective and knowledgeable use of diagnostic tests and procedures, are essential to the diagnostic process. Diagnostic laparoscopy represents the reference standard for diagnosis of many of its possible causes and can obviate the need for exploratory laparotomy. Once competing diagnoses have been adequately excluded, an empiric trial of antibiotic therapy for acute pelvic inflammatory disease, coupled with close clinical follow-up, should be considered in patients with acute pelvic pain found to have cervical motion tenderness and bilateral adnexal tenderness on examination.

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MeSH descriptors

Pain Pelvis Acute Disease Diagnosis, Differential Female Genital Diseases, Female Genital Diseases, Female Genital Diseases, Female Humans Pain Pelvic Inflammatory Disease Pelvic Inflammatory Disease Pregnancy Pregnancy Complications Pregnancy Complications

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