Abdominalgias de causa ginecológica: una realidad en adolescentes

S. Fernández Ávalos, David Muñoz-Santanach, Victoria Trenchs Sáinz de la Maza, C. Luaces Cubells
In: Anales de Pediatría · 2010 · vol. 72(5) , pp. 339–342 · doi:10.1016/j.anpedi.2009.12.013 · PMID:20335082 · W1980885119
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This study evaluated 699 adolescents with abdominal pain, finding that 7.7% had gynecological causes, most commonly peri-ovular pain and dysmenorrhea, with a small percentage requiring hospitalization or surgery.

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Abstract

ObjectiveTo determine the prevalence, the presentation, the evaluation and the evolution of abdominal pain of gynaecological cause in adolescents who came to a Paediatric Emergency Department.MethodsAn observational and descriptive study was performed. All adolescent female aged 12 to 18 years who came to Emergency Service during 2008 with abdominal pain were included. The patients diagnosed with gynaecological disorders were studied.ResultsSix hundred and ninety-nine adolescents with abdominal pain were evaluated and 54 (7,7%) of them were of gynaecological cause. Their mean age was 15,2 (SD 1,7) years. Fifty-one (94,4%) had had the menarche. Thirteen (59,3%) of the 32 adolescents, who were asked, said that they had had sex. The median evolution of pain was 2 days (p25-75: 6hours-4days). The most frequent associated symptoms were micturition syndrome (11; 20,4%) and vomiting (9; 16,7%). Thirty-one (57,4%) adolescents were evaluated by two or more specialists. Forty-two (77,7%) patients were subjected to complementary examinations; abdominal ultrasound (29; 53,7%) and urinary sediment (26; 48,1%) were the two most common. The main diagnoses were peri-ovular pain (16; 29,6%) and dysmenorrhoea (14; 25,9%). Six (9,3%) patients were admitted to the hospital and 4 (7,4%) needed surgery.ConclusionsAlthough the main causes of abdominal pain in adolescent females are physiological, an accurate anamnesis and physical examination is essential to rule out other more serious causes. A multidisciplinary evaluation is often necessary to make a correct diagnosis.

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