Pelvic pain
This page is for adult patients. For pediatric patients, see: Prepubertal pelvic pain.
Background
- This page outlines the general approach to pelvic pain
Classification by Abdominal pain location
RUQ pain | Epigastric pain | LUQ pain |
Flank pain | Diffuse abdominal pain | Flank pain |
RLQ pain | Pelvic pain | LLQ pain |
Clinical Features
- Post-pubertal pelvic pain
Differential Diagnosis
Acute Pelvic Pain
Gynecologic/Obstetric
- Normal variants may be noted on exam but generally do not cause pain or other symptoms
- Nabothian cysts: Epithelial cells within mucous glans that appear as yellow inclusions on the cervix
- Cervial Ectropion: Edothelial cells on the exterior of the cervix
- Parous cervix: The is no longer round but may have multiple shapes after birth
- Pregnancy-related
- Ectopic Pregnancy
- Spontaneous abortion, threatened or incomplete
- Septic abortion
- Pelvic organ prolapse
- Acute Infections
- Vulvovaginitis
- Adnexal Disorders
- Hemorrhage/rupture of ovarian cyst
- Ovarian torsion
- Twisted paraovarian cyst
- Other
- Myoma (degenerating)
- Genitourinary trauma
- Ovarian hyperstimulation syndrome
- Sexual assault
- Recurrent
- Mittelschmerz
- Primary/Secondary Dysmenorrhea
- Pelvic Congestion Syndrome
- Endometriosis
Genitourinary
Gastrointestinal
- Gastroenteritis
- Appendicitis
- Bowel obstruction
- Perirectal abscess
- Diverticulitis
- Inflammatory bowel disease
- Irritable bowel syndrome
- Mesenteric adenitis
Musculoskeletal
- Abdominal wall hematoma
- Psoas hematoma, psoas abscess
- Hernia
Vascular
- Pelvic thrombophlebitis
- Abdominal aortic aneurysm
- Ischemic bowel (Mesenteric Ischemia)
Postmenopausal Pelvic Pain
Gynecologic
- Vulvovaginitis
- Atrophic vaginitis
- Infectious (STI)
- Allergic
- Uterine prolapse
- Cystocele
- Rectocele
- Enterocele
- Uterine/Vaginal Vault Prolapse
- Cervical polyps
- Uterine fibroids
- Endometrial hyperplasia
- Neoplasm
- Uterine
- Ovarian
Gastrointestinal
- Rectocele
- Diverticulitis
- Neoplasm
- Appendicitis
- Ischemic Bowel (Mesenteric Ischemia)
Urologic
- Infection
- Cystourethrocele
Prepubescent-Urethral prolapse
Urologic
- Sarcoma botryoides
Evaluation
Workup
- Pregnancy test
Diagnosis
Management
Disposition
See Also
External Links
References
- ↑ Norris DL, Young JD. UTI. EM Clin N Am. 2008; 26:413-30.