Acute Pelvic Pain

Abstract

There is often no clear-cut historical or physical feature which can distinguish between abdominal and pelvic causes of acute pain. As such, the differential diagnosis of acute pelvic pain in women is quite extensive, and there is considerable overlap between gastrointestinal and genitourinary symptomatology. For example, appendicitis, diverticulitis, and inflammatory bowel disease are all capable of causing adnexal pain and cervical motion tenderness. Ectopic pregnancy and pelvic inflammatory disease can cause shock and sepsis. This algorithm will address the “emergency room” approach to acute pelvic pain, discussing those conditions which must be considered even in those patients with suspected appendicitis.