Abstract
Acute lower abdominal and pelvic pain in premenopausal women has a wide range of etiologies including gastrointestinal, urological, obstetrical, and gynecological causes. Specifically, in younger patients, it is difficult to localize the pain during both history and physical examination, making it a diagnostic challenge. Life- and/or fertility-threatening conditions are the first to be considered until they can be confidentially excluded. History, physical examination, and laboratory testing narrow the differential diagnosis and guide the physician to choose the proper imaging test. Ultrasound is the recommended initial imaging tool for pregnant and nonpregnant women and girls presenting with acute pelvic pain and in which a gynecological etiology is suspected.
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