Other non-gynaecological causes of acute pelvic pain

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Other non-gynaecological causes of acute pelvic pain

Chapter 14 – Acute Pelvic Pain and Other Gynaecological Emergencies

Topic

Acute pelvic pain and other gynaecological emergencies: An Introduction
Acute pain
Other non-gynaecological causes of acute pelvic pain
Vaginal bleeding
Cervical shock
Sepsis
Post-operative complications
Resources
References

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Other non-gynaecological causes of acute pelvic pain

Appendicitis: usually presents with right iliac fossa pain and systemic features which may include fever, anorexia and vomiting. Pain may commence at the umbilicus before migrating to the right iliac fossa.⁽³⁾ Adnexal tenderness may be present on pelvic examination.⁽¹⁵⁾ Computed tomography (CT) scan has a higher sensitivity and specificity than ultrasound in the diagnosis of acute appendicitis.⁽¹⁵⁾ Definitive diagnosis is made at the time of surgery. Prompt referral to hospital is recommended if appendicitis is suspected. Diverticulitis: an important differential, especially in patients aged over 40, and typically presents with left sided pain with or without associated rectal bleeding. CT scan may show changes associated with diverticular disease.⁽¹⁵⁾ In some cases, abscess formation and bowel perforation can occur. Urinary tract pathology including infection or renal calculi. ... Buy now

Gupta S, Manyonda I. Acute Complications of Fibroids. Best Practice & Research Clinical Obstetrics and Gynaecology. 2009;23(2009):609-17.

Stratton P. Evaluation of acute pelvic pain in nonpregnant adult women. UpToDate; 2018.

GP Differential Diagnoses: Common causes of low abdominal (pelvic) pain in women of reproductive age [internet].Sexually Transmissible Infections Program Unit (STIPU). Available from: https://stipu.nsw.gov.au/wp-content/uploads/GP_Differential-diagnoses_V1.pdf.

Polena V, Huchon C, Varas Ramos C, Rouzier R, Dumont A, Fauconnier A. Non-invasive Tools for the Diagnosis of Potentially Life Threatening Gynaecological Emergencies: A Systematic Review. PLoS ONE. 2015;10(2):e0114189.

Breeze C. Early Pregnancy Bleeding. AFP. 2016;45(5).

Kadar N, Caldwell BV, Romero R. A method of screening for ectopic pregnancy and its indicators. Obstet Gynecol. 1981;58(2):162-6.

Elson C, Salim R, Potdar N, Chetty M, Ross JA, Kirk EJ on behalf of the Royal College of Obstetricians and Gynaecologists,. Diagnosis and management of ectopic pregnancy. BJOG. 2016;123:e15-e55.

Queensland Health. Queensland Clinical Guidelines: Maternity and Neonatal Clinical Guidelines: Early Pregnancy Loss [internet]. Queensland Government; 2017 May [amended 2018 May]. Available from: https://www.health.qld.gov.au/__data/assets/pdf_file/0010/140131/s-epl.pdf .

The Royal Hospital for Women. Methotrexate for Ectopic Pregnancy. Local Operating Procedure: Clinical policies, procedure and guidelines. [Internet]. 2017.

10.

NSW Health. Maternity – Management of Early Pregnancy Complications. PD2012_022. [Internet]. NSW Government; 2012. Available from: https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2012_022.pdf .

11.

National Institute for Health and Care Excellence (NICE). Ectopic pregnancy and miscarriage: diagnosis and initial management. NG126. [Internet]. NICE; 2019 [2019 April]. Available from: https://www.nice.org.uk/guidance/ng126/resources/ectopic-pregnancy-and-miscarriage-diagnosis-and-initial-management-pdf-66141662244037 .

12.

Miscarriage [Internet]. The Women’s: The Royal Women’s Hospital. Available from: https://www.thewomens.org.au/health-information/pregnancy-and-birth/pregnancy-problems/early-pregnancy-problems/miscarriage.

13.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). College Statement C-Obs 29a: Progesterone support of the luteal phase and in the first trimester. [Internet]. RANZCOG; 2009 [updated 2018 March]. Available from: https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Progesterone-support-of-the.pdf?ext=.pdf.

14.

Bottomley C, Bourne T. Diagnosis and management of ovarian cyst accidents. Best Practice & Research Clinical Obstetrics & Gynaecology. 2009 Oct;23(5):711-24.

15.

Brent K, Agraval J. Ouch! Acute pelvic pain. O&G Magazine. Autumn 2015;17(1).

16.

Royal College of Obstetricians and Gynaecologists. The Management of Ovarian Hyperstimulation Syndrome. Green-top Guideline No.5. [Internet]. NICE; 2016 Feb. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/green-top-guidelines/gtg_5_ohss.pdf.

17.

Vloeberghs V, Peeraer K, Pexsters A, D’Hooge T. Ovarian Hyperstimulation Syndrome and Complications of ART. Best Practice & Research Clinical Obstetrics and Gynaecology. 23(2009):691-709.

18.

Fischerova D. Care in Gynaecology: Resuscitation and Management of sepsis and acute blood loss. Best Practice & Research Clinical Obstetrics and Gynaecology. 2009;23(2009):679-90.

19.

Baird A, Dickson J, Jensen M, Talbot M. Syncope and profound bradycardia associated with intrauterine contraceptive procedures. J Fam Plann Reprod Health Care. 2012;38:191-3.

20.

The Faculty of Sexual & Reproductive Healthcare (FSRH) Clinical Standards Committee. Service Standards for Resuscitation in Sexual and Reproductive Healthcare – August 2016. [Internet]. FSRH; 2016. Available from: https://www.fsrh.org/standards-and-guidance/documents/service-standards-for-resuscitation-in-sexual-and-reproductive/.

21.

NSW Health. Rural Adult Emergency Clinical Guidelines. [Internet]. NSW Government; 2016.

22.

Australian Resuscitation Council. The Australian Resuscitation Council Guidelines. [Internet]. Australian Resuscitation Council; 2000 [updated 2020 November]. Available from: https://resus.org.au/guidelines/.

23.

Ramphal S, Moodley J. Emergency Gynaecology. Best Practice & Research Clinical Obstetrics and Gynaecology. 2006;20(5):729e50.

24.

Tulandi T, Al-Fozan HM. Spontaneous Abortion: Management. UpToDate; 2019.

25.

Bora S, Condous G. Bartholins, Vulval and perineal abscesses. Best Practice & Research Clinical Obstetrics and Gynaecology. 2009;23(2009):661-6.

26.

SA Health. Toxic shock syndrome (TSS) – including symptoms, treatment and prevention [internet]. Government of South Australia. Available from: https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/toxic+shock+syndrome/toxic+shock+syndrome+tss+-+including+symptoms+treatment+and+prevention.

27.

Budden A. Q&A: What is the role of a menstrual cup? O&G Magazine. Summer 2018;20(4).

28.

Lam A, Kaufman Y, Khong SY, Liew A, Ford S, Condous G. Dealing with Complications in Laparoscopy. Best Practice & Research Clinical Obstetrics and Gynaecology. 2009;23:631-46.

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Reproductive and Sexual Health Handbook

Chapter 14 – Acute Pelvic Pain and Other Gynaecological Emergencies

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Other non-gynaecological causes of acute pelvic pain