This review aims to: 1) Revisit the common causes of pelvic pain of gynaecological origin 2) Provide a structured ultrasound evaluation approach 3) Pictorially illustration of pathologies commonly encountered

Pelvic Pain in female patients is a common problem in the Emergency Department. The majority of patients are premenopausal and a pregnancy test is a crucial determinator in the pathological pathway. Causes of Pelvic Pain can be divided into those of gynaecological and non-gynaecological origin. Gynaecologic pain can be acute or chronic. Acute gynaecologic pain can result from infection, formation of a cyst/tumour and its associated complications, or torsion of a gynaecologic structure. Pain from chronic gynaecologic conditions include: endometriosis, adenomyosis, mittleschmerz, dysmenorrhoea, pelvic congestion...

Chronic Pelvic Pain (endometriosis, adenomyosis, mittleschmerz, dysmenorrhea, pelvic congestion syndrome) Endometriosis Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterus, most commonly implanted on the surface of the ovary, uterus, fallopian tube, or on the uterine suspensory ligaments and/or peritoneal surface of the pouch of Douglas. Patients present with chronic pain that is often cyclical in nature. Acute pain can occur from rupture of endometrioma. Endometriomas are complex cystic masses. US finding of uniform low-level echogenicity or a ground-glass appearance is...

Multiple entities, including normal physiologic changes may cause acute pelvic pain in premenopausal women. For initial diagnostic imaging TV ultrasound is the modality of choice and helps in distinguishing gynaecological from non-gynaecological and surgical from non-surgical pathology. Correlation with clinical history and knowledge of ultrasound appearance of various normal and abnormal gynaecologic conditions allow their accurate diagnosis and expeditious management.

R. Mehta1, D. Tzias2, A. K. Sian3,K. L. Shahabuddin4, A. Javed, W. Pienaar St George's Hospital, Chelsea and Westminster Hospital, Medway Maritime Hospital, Kingston Hospital.

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