Gynecologic Emergencies in the Nonpregnant Patient

Abstract

Nonpregnant patients with gynecologic emergencies often present with pelvic pain that may or may not be unilateral. Many gynecologic emergencies are associated with high morbidity and, occasionally, mortality if left untreated. This review examines the assessment and stabilization, diagnosis, and treatment and disposition of patients with various gynecologic emergencies, including ovarian torsion, cervicitis, pelvic inflammatory disease, uterine fibroids, endometriosis, dysfunctional uterine bleeding, Bartholin cysts, and vulvovaginitis. Figures show an algorithm of gynecologic emergencies, a longitudinal sonogram and a computed tomography (CT) scan showing ovarian torsion, a CT scan and sonogram of a tubo-ovarian abscess, and illustrations of a Bartholin cyst and a Word catheter. Tables list assessment, stabilization, and management guidelines for the subtopics in this review. This review contains 7 figures, 15 tables, and 68 references. Keywords: Ovarian torsion, cervicitis, uterine fibroids, endometriosis, Bartholin’s cyst, vulvovaginitis, sexually transmitted infection, bleeding.