Pelvic pain causes: Difference between revisions
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| Line 56: | Line 56: | ||
*Sensitivity | *Sensitivity | ||
*Onset | *Onset | ||
*Pain occurrence | *[[Pain]] occurrence | ||
:* | :*[[Intercourse]] | ||
:* | :*[[Menstrual]] | ||
:* | :*Chronic vs. acute | ||
*Risk of pregnancy | *Risk of [[pregnancy]] | ||
*Associated symptoms: | *Associated symptoms: | ||
:*[[ | :*[[Fever]] | ||
:*[[ | :*[[Nausea]] | ||
:*[[ | :*[[Vomiting]] | ||
:*[[ | :*[[Dysuria]] | ||
:*[[ | :*[[Vaginal bleeding]] | ||
:*[[ | :*[[Vaginal discharge]] | ||
:*[[ | :*[[Abdominal pain]] or [[back pain]] | ||
=== Abdomen === | === Abdomen === | ||
*Full abdominal | *Full abdominal and pelvic exam - speculum, bimanual, rectal | ||
=== Other === | === Other === | ||
*Examine for signs of physical abuse | *Examine for signs of [[physical abuse]] | ||
=== Laboratory Findings === | === Laboratory Findings === | ||
*Labs include: | *Labs include: | ||
:*Urine [[pregnancy test]] | :*Urine [[pregnancy test]] | ||
:*[[ | :*[[Urinalysis]] | ||
:*[[ | :*[[Gram stain]] and [[culture]] | ||
:*[[STD]] tests | :*[[STD]] tests | ||
:*vaginal smear wet mount | :*vaginal smear wet mount | ||
Revision as of 03:04, 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
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 and pelvic exam - speculum, bimanual, rectal
Other
- Examine for signs of physical abuse
Laboratory Findings
- Labs include:
- Urine pregnancy test
- Urinalysis
- Gram stain and 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