Some Clues to Diagnosis of Pelvic Pain
Finding | Possible Diagnosis |
|---|---|
Syncope or hemorrhagic shock | Ruptured ectopic pregnancy Possibly a ruptured ovarian cyst |
Vaginal discharge, cervical motion tenderness, uterine and adnexal tenderness; sometimes fever | Pelvic inflammatory disease, with possible tubo-ovarian abscess |
Sudden onset of severe pain, sometimes localized to one side or with nausea | Ruptured ovarian cyst |
Epigastric or periumbilical pain, followed by brief nausea and anorexia, then by fever and right lower quadrant pain (sometimes with cervical motion tenderness) | |
Constipation, diarrhea, relief or worsening of pain during defecation; sometimes rectal bleeding | Other gastrointestinal disorders |
Left lower quadrant pain and tenderness in patients > 40 years, sometimes with fever | |
Tenderness in the suprapubic area or anterior vaginal wall with chronic or recurrent urinary symptoms (dysuria, urinary frequency or urgency) | Lower urinary tract disorder (eg, interstitial cystitis [painful bladder syndrome]), causing bladder or urethral pain |
Fixed, immobile uterus or adnexa | Gynecologic or other pelvic cancer |
Adnexal mass, sometimes with tenderness | Ovarian cyst or tumor Tubo-ovarian abscess |
Acute, painful defecation plus localized, tender, fluctuant mass felt during internal or external rectal examination; with or without fever |