Learning objectives
To explain the normal physiologic processes that can lead to the development of lesions causing acute pelvic pain in women.
To detail the most common causes of acute pelvic pain in women within the reproductive period and describe their typical US appearances.
Background
Acute pelvic pain is a common complaint in premenopausal women that may result from multiple causes. An accurate diagnosis based on imaging is important to distinguish between emergency conditions that need urgent surgical management and those which can be managed conservatively. It is important for the radiologist to understand the common gynecologic causes of acute pelvic pain and their non-gynecologic mimics.Ultrasound is the modality of choice for initial imaging of women with acute pelvic pain.
Findings and procedure details
Gynecologic causes of acute pelvic pain:
Functional and hemorrhagic ovarian cysts:
Follicular cyst:
During the first half of the menstrual cycle, many ovarain follicles enlarge under the effect of FSH & eventually one or more turn into a dominant follicle which usually measures about 18 -25 mm. Ovulation is then triggered by the surge of LH and the dominant follicle converts into corpus luteum.If a dominant follicle fails to expel an oocyte, it may further enlarge in size forming a follicular cyst which appears as...
Conclusion
Ultrasonography is an ideal imaging modality that plays a significant role in the prompt & accurate diagnosis and expeditious management of adnexal causes of acute pelvic pain in women of reproductive age and the accuracy of examination is increased by adding color Doppler.
Personal information and conflict of interest
R. A. Anan:
Nothing to disclose
A. A. Singh:
Nothing to disclose
G. A. Saleh:
Nothing to disclose
E. Taha:
Nothing to disclose
D. K. Khedr:
Nothing to disclose
References
Angle, RH., Ackerman, SJ. and Irshad, A. "Practical imaging of acute pelvic pain in premenopausal women."Contemporary Diagnostic Radiology2010;33:1-6.
Dupuis, CS., & Kim, YH. "Ultrasonography of adnexal causes of acute pelvic pain in pre-menopausal non-pregnant women."Ultrasonography 2015;34:258.
Fadl, SA., Linnau, KF. and Dighe, MK. "Placental abruption and hemorrhage—review of imaging appearance." Emergency radiology 2019;26: 87-97.
Ignacio EA, & Hill MC. Ultrasound of the acute female pelvis. Ultrasound Quarterly 2003;19:86-98.
Lin, EP., Bhatt S., and Dogra VS. "Diagnostic clues to ectopic pregnancy."Radiographics 2008;28:1661-1671.
Lipscomb GH, Stovall TG,...