Imaging of Acute Gynecologic Disorders

In: Emergency Radiology · 2024 · pp. 181–193 · doi:10.1007/978-3-031-65770-2_13 · W4404366162
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Transvaginal and transabdominal ultrasound are the primary imaging modalities for evaluating acute pelvic pain suspected to be gynecological in origin, regardless of pregnancy status or etiology.

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This chapter reviews imaging approaches for acute gynecologic disorders in emergency settings, focusing on pelvic pain workups using high-level clinical context (including age and pregnancy testing) and the selection of ultrasound as first-line imaging. It emphasizes that transvaginal and/or transabdominal ultrasound are the “workhorse” modalities for suspected gynecologic etiologies, with equal appropriateness regardless of pregnancy status or whether a gynecologic versus nongynecologic cause is considered, and notes that serum beta-hCG testing should be performed if pregnancy is possible. The chapter’s main limitation is that it provides an overview of common conditions and imaging roles rather than presenting new, original comparative study results. Relevance to endometriosis: the chapter explicitly lists endometriosis among common causes of pelvic pain evaluated in the emergency differential and is therefore directly applicable to endometriosis-related acute pelvic pain imaging.

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Abstract

Pelvic pain is one of the most common causes for presentation to the emergency department. A variety of gynecological processes may be the etiology for pelvic pain; hemorrhagic ovarian cysts, pelvic inflammatory disease, ovarian torsion, endometriosis, cystitis, ovarian vein thrombosis, and ovarian hyperstimulation syndrome are a few of the most commonly encountered pathologies. Before medical imaging is performed for the evaluation of pelvic pain, it is important to obtain relevant clinical history and review available laboratory information. The patient’s age and pregnancy status are of particular importance in the differential diagnosis; therefore, serum beta-hCG laboratory evaluation is performed if there is even a remote possibility of pregnancy. Transvaginal and transabdominal ultrasound are the workhorse modalities for the evaluation of pelvic pain when a gynecological etiology is suspected. Transvaginal and/or transabdominal ultrasound are both considered equally appropriate when evaluating pelvic pain; this is true whether the serum beta-hCG is positive or negative and whether a gynecologic or nongynecologic etiology is suspected. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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