Type:
Educational Exhibit
Keywords:
Genitourinary, Genital / Reproductive system female, Pelvis, CT, MR, eLearning, Surgery, Haemorrhage, Infection, Inflammation, Retrospective, Observational, Performed at one institution
Authors:
E. Younsi1, O. Ghdes2, M. A. Elaoud3, A. Ben Miled2, M. Jrad2; 1Montfleury/TN, 2TUNIS/TN, 3Sfax/TN
DOI:
10.26044/ecr2020/C-05578
Background
Acute pelvic pain is a frequent reason for emergency consultation (around 5% in gynecology departments). It is defined as pain in the lower abdomen or pelvis lasting less than three months . Rigorous semiological analysis of pain and a careful clinical examination are important for accurate diagnosis of the gynecological or extra gynecological origin of the pain.
Two dogmas are important to mention in a context of gynecological causes of acute pelvic pain: any pre-menopausal woman could potentially have an ectopic pregnancy and any patient with a biological inflammatory syndrome could have a pelvic inflammatory disease (PID).
Etiological orientation of the pain depends on : the patient’s age, genital evolution stage (puberty, genitally active period, pregnancy, climateric period); the clinical context:medical or surgical history, contraception, sudden or progressive onset of the pain, fever, associated signs (leucorrhea, breakthrough bleeding, urinary symptoms);and biological context: Beta-HCG values, biological inflammatory syndrome .
CT and MRI imaging integrates, almost systematically, into the diagnostic approach of gynecological diseases that cause acute pelvic pain, therefore, radiologists must know which imaging modality is most appropriate for a fast and accurate diagnosis.