Pelvic pain causes: Difference between revisions
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===Acute (<6 months)=== | ===Acute (<6 months)=== | ||
*[[Abdominal | *[[Abdominal aortic aneurysm]] | ||
*[[Cervicitis]] | *[[Cervicitis]] | ||
*[[Diverticulitis]] | *[[Diverticulitis]] | ||
*Ectopic pregnancy | *[[Ectopic pregnancy]] | ||
*[[Endometriosis]] | *[[Endometriosis]] | ||
*Incomplete abortion | *Incomplete [[abortion]] | ||
*Intra-uterine device | *[[Intra-uterine device]] | ||
*[[Irritable Bowel Syndrome]] | *[[Irritable Bowel Syndrome]] | ||
*Midcycle ovulation | *[[Midcycle ovulation]] | ||
*Mesenteric ischemia/infarction | *[[Mesenteric ischemia]]/[[Mesenteric ischemia|infarction]] | ||
*[[Nephrolithiasis]] | *[[Nephrolithiasis]] | ||
*[[Ovarian cyst]] | *[[Ovarian cyst]] | ||
*[[Ovarian torsion]] | *[[Ovarian torsion]] | ||
*[[Pelvic Inflammatory Disease]] | *[[Pelvic Inflammatory Disease]] | ||
*Pelvic neoplasm | *Pelvic [[neoplasm]] | ||
*Pelvic floor prolapse | *[[Pelvic floor]] [[prolapse]] | ||
*Primary dysmenorrhea | *[[Primary dysmenorrhea]] | ||
*Ruptured corpus | *Ruptured corpus luteal cyst | ||
*Septic abortion | *[[Septic abortion]] | ||
*Sexual abuse/trauma | *[[Sexual abuse]]/[[trauma]] | ||
*Threatened abortion | *Threatened [[abortion]] | ||
*Tubo-ovarian abscess | *[[Tubo-ovarian abscess]] | ||
*[[Urinary Tract Infection]] | *[[Urinary Tract Infection]] | ||
*Uterine fibroids | *[[Uterine fibroids]] | ||
*[[Vaginitis]] | *[[Vaginitis]] | ||
Revision as of 02:08, 31 January 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pain in the pelvis can be described as acute or chronic. Urologic, gastrointestinal and gynocologic problems can all be possible.
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:
Abdomen
- Full abdominal & pelvic exam - speculum, bimanual, rectal
Other
- Examine for signs of physical abuse
Laboratory Findings
- Labs include:
- Urine pregnancy test
- urinalysis
- gram stain & culture
- STD tests
- vaginal smear wet mount
Echocardiography or Ultrasound
- Ultrasound for ovarian cyst, mass, ectopic pregnancy vs. intrauterine pregnancy
Treatment
- Positive pregnancy test
- Determine LMP
- confirm intrauterine pregnancy
Acute Pharmacotherapies
- Endometriosis
- Oral contraceptives 3-4 months
- Provera 39mg QD/2 months
- Danazol 200-800mg QD/6 month
- GnRH agonist
- Primary dysmennorhea
- Oral contraceptives
- Treat STD's accordingly