Imaging of Acute Gynecologic Disorders

In: Emergency Radiology · 2017 · pp. 189–201 · doi:10.1007/978-3-319-65397-6_13 · W4255030885
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This review discusses the utility of ultrasound and other imaging modalities in diagnosing acute gynecologic conditions presenting as pelvic pain.

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This paper is an emergency radiology overview of acute gynecologic disorders causing pelvic pain, describing the diagnostic workup in an emergency department setting. It emphasizes obtaining relevant clinical history and laboratory data, including serum beta-hCG when pregnancy is possible, and using transvaginal and/or transabdominal ultrasound as the primary “workhorse” modalities when a gynecologic etiology is suspected. A key caveat is that the abstract does not present original imaging results or evidence levels for specific conditions, focusing instead on general diagnostic principles and modality selection, with limited explicit detail beyond the listed example pathologies. Relevance to endometriosis: the chapter explicitly lists endometriosis among common etiologies of pelvic pain and cites multiple endometriosis imaging references, though its main focus is broad imaging of acute gynecologic disorders.

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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 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. Similar content being viewed by others

References

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