Acute Pelvic Pain

In: Emergency Medicine Clinics of North America · 2019 · vol. 37(2) , pp. 207–218 · doi:10.1016/j.emc.2019.01.012 · PMID:30940367 · W2926413397
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AI-generated summary by claude@2026-07, 2026-07-24

Emergency physicians face challenges in differentiating gynecologic from nongynecologic causes of acute pelvic pain, with ultrasound limitations requiring consideration for exploratory laparotomy in suspected adnexal torsion.

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Abstract

Acute pelvic pain has gynecologic and nongynecologic causes, and distinguishing between them can be difficult in the emergency department. Ovarian cysts, adnexal torsion, and pelvic inflammatory disease are conditions that emergency physicians must be able to identify. Pelvic pathologic condition can be readily assessed with ultrasound but has significant limitations. Adnexal torsion can occur despite normal vasculature on ultrasound with Doppler; patients with significant pain or risk factors may require exploratory laparotomy. Emergency physicians and clinicians must be prepared to manage all aspects of pelvic emergencies, both gynecologic and nongynecologic.

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