Pelvic pain causes: Difference between revisions
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==Overview== | ==Overview== | ||
[[Pain]] in the [[pelvis]] can be described as acute or chronic. Urologic, gastrointestinal and gynecologic problems can all be possible. | [[Pain]] in the [[pelvis]] can be described as acute or chronic. Urologic, gastrointestinal and gynecologic problems can all be possible. | ||
== Causes == | ==Causes== | ||
===Life Threatening Causes=== | |||
===Common Causes=== | |||
===Causes by Organ System=== | |||
===Causes in Alphabetical Order <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>=== | ===Causes in Alphabetical Order <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>=== | ||
Revision as of 13:37, 7 August 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2]
Overview
Pain in the pelvis can be described as acute or chronic. Urologic, gastrointestinal and gynecologic problems can all be possible.
Causes
Life Threatening Causes
===Common Causes===
Causes by Organ System
Causes in Alphabetical Order [1] [2]
Acute (<6 months)
- Abdominal aortic aneurysm
- Cervicitis
- Diverticulitis
- Ectopic pregnancy
- Endometriosis
- Incomplete abortion
- Intra-uterine device
- Irritable bowel syndrome
- Midcycle ovulation
- Mesenteric ischemia/infarction
- Nephrolithiasis
- Ovarian cyst
- Ovarian torsion
- Pelvic inflammatory disease
- Pelvic neoplasm
- Pelvic floor prolapse
- Primary dysmenorrhea
- Ruptured corpus luteal cyst
- Septic abortion
- Sexual abuse/trauma
- Threatened abortion
- Tubo-ovarian abscess
- Urinary tract infection
- Uterine fibroids
- Vaginitis
Chronic (>6 months)
- Adenomyosis
- Depression
- Diverticulosis
- Diverticular abscess
- Hernia
- IBD
- IBS
- Interstitial Cystitis
- Leiomyoma
- Lymphoma
- Pelvic adhesions
Diagnosis
History and Symptoms
- Nature
- Sensitivity
- Onset
- Pain occurrence
- Intercourse
- Menstrual
- Chronic vs. acute
- Risk of pregnancy
- Associated symptoms:
Physical Examination
Abdomen
- Full abdominal and pelvic exam - speculum, bimanual, rectal
Others
- Examine for signs of physical abuse
Laboratory Findings
- Labs include:
- Urine pregnancy test
- Urinalysis
- Gram stain and culture
- STD tests
- Vaginal smear wet mount
Ultrasound
- Ultrasound for ovarian cyst, mass, ectopic pregnancy vs. intrauterine pregnancy
Treatment
Medical Therapy
Acute Pharmacotherapies
- Oral contraceptives 3-4 months
- Provera 39mg QD/2 months
- Danazol 200-800mg QD/6 month
- GnRH agonist
- Treat STD's accordingly