Computed tomography and magnetic resonance imaging findings in acute pelvic pain of gynecological origin

Genitourinary, Genital / Reproductive system female, Pelvis, CT, MR, eLearning, Surgery, Haemorrhage, Infection, Inflammation, Retrospective, Observational, Performed at one institution Authors: E. Younsi1, O. Ghdes2, M. A. Elaoud3, A. Ben Miled2, M. Jrad2; 1Montfleury/TN, 2TUNIS/TN, 3Sfax/TN DOI: 10.26044/ecr2020/C-05578 Learning objectives - To keep in mind the main gynecological diseases that cause acute pelvic pain according to the clinical-biological context - To appropriately indicate the various imaging modalities, in particular the abdominal and pelvic computed tomography (CT) and magnetic resonance imaging (MRI) in the context of acute pelvic pain of gynecologic origin - To describe the CT and MRI findings of the different gynecological diseases that cause acute pelvic pain

Acute pelvic painis a frequent reason for emergency consultation (around 5% in gynecology departments). It is defined as pain in the lower abdomen or pelvis lasting less than three months. Rigorous semiological analysis of pain and a careful clinical examination are important for accurate diagnosis of the gynecological or extra gynecological origin of the pain. Two dogmas are important to mention in a context of gynecological causes of acute pelvic pain: any pre-menopausal woman could potentially have an ectopic pregnancy and any patient with a... Findings and procedure details 1. Genitally active period: a-Ectopic pregnancy: First and foremost, incase of acute pelvic pain in genitally active period, pelvic imaging will aim to eliminate at first an ectopic pregnancy which constitutes a leading cause of maternal death. Main risk factors are tubal surgery or pelvic inflammatory disease(PID)history, intrauterine device, medically assisted reproduction and endometriosis. It mostly occurs in the ampullary and isthmic portions of the fallopian tube.Clinical context is made of amenorrhea, spotting, unilateral pelvic pain and haemorrhagic shock in case of rupture with positive...

Even if ultrasonography remains the first-line exam, CT and MRI imaging plays a pivotal role, guided by the patient clinical history and biological findings, in assessing acute pelvic pain of gynecologic origin. Knowledge of the common CT and MRI appearances of various gynecological diseases allows their accurate diagnosis and expeditious management. Personal information and conflict of interest E. Younsi; Montfleury/TN - nothing to disclose O. Ghdes; Tunis/TN - nothing to disclose M. A. Elaoud; Sfax/TN - nothing to disclose A. Ben Miled; Tunis/TN - nothing to disclose M. Jrad; Tunis/TN - nothing to disclose

1.CT and MR Imaging Features of Adnexal Torsion. RadioGraphics. 2002;2(22). 2. Knoepp US, Mazza MB, Chong ST, Wasnik AP. MR Imaging of Pelvic Emergencies inWomen. Magn Reson Imaging Clin N Am. 2017;25(3):503‑19. 3.Somberg Gunther M, Kanmaniraja D, Kobi M, Chernyak V. MRI of Acute Gynecologic Conditions. J Magn Reson Imaging. 2019. 4.Park SB. The role of ultrasound in the evaluation of acute pelvic pain in pregnancy and postpartum period: a review. Curr Opin Obstet Gynecol. 2018;30(6):369‑77.