Imaging of Acute Pelvic Pain

Vandermeer, Fauzia Q.; Wong-You-Cheong, Jade J.

doi:10.1097/grf.0b013e3181958173

Cited by 71 publications

(104 citation statements)

References 30 publications

(44 reference statements)

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“…Ultrasound is excellent for visualizing uterine enlargement, endometrial thickening or presence of fluid, increased ovarian size (with or without evidence of abscesses), hydrosalpinx as well as pyosalpinx 15 Thick-walled, tubular adnexal masses (with or without free fluid in the pelvis) have been reported to have a sensitivity or 85% and specificity of 100% for the diagnosis of PID. 16 As PID becomes more severe, other imaging modalities (MRI/CT) may be more beneficial in distinguishing soft tissue structures better than US (Figure 3).…”

Section: Pelvic Inflammatory Disease/ Tubo-ovarian Abscessmentioning

confidence: 99%

Imaging Modalities in Gynecology

Busse¹

2010

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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REVIEW ARTICLE DSJUOG ULTRASOUNDTransabdominal gynecologic ultrasound combined with transvaginal scanning is a technique that was initially introduced in the early 1980's and quickly became a "musthave" procedure for gynecologists and emergency room physicians for assistance in diagnosing many gynecologic conditions. Rapid advances in the quality of the equipment, techniques used to obtain best images, and research designed to help physicians interpret their findings have contributed to ultrasound's quick rise in use and popularity. It is ubiquitous that ultrasound is the imaging modality of choice for gynecologic conditions.The advantages of ultrasound are numerous. It is fast, easy to obtain, has a high patient tolerance and is relatively inexpensive when compared to CT and MRI. Many physicians' offices have ultrasound machines that are more than sufficient to make common diagnoses thereby alleviating patient anxiety and physician concerns if an abnormality is found during a physical exam. Appropriate referrals and treatments can be initiated in a timely manner at minimum expense. The ability to use the transvaginal ultrasound as an extension of a pelvic exam is extremely useful, particularly when the source of pain is uncertain during bimanual exam or if a mass is found of uterine or ovarian origin. An obvious advantage, especially when compared to CT, is that no radiation exposure occurs. As will be discussed in more detail, pelvic ultrasound has been shown, in numerous studies, to have a high negative predictive value and offers excellent resolution of the uterus and adnexal structures, especially when compared to CT and MRI.There are disadvantages; however, that should be addressed. Even with routine use of transabdominal scanning which utilizes the acoustic window of a full bladder, the field of view is very limited, especially, compared to CT and MRI. Transvaginal sonography limits the field; however, it is effective in obtaining excellent resolution of the uterus, endometrium and adnexal structures. Ultrasound visualizes the bowel poorly and it is well-known that bowel gas corrupts the ultrasound signal allowing for potential "missed" masses not visible under the bowel. An additional drawback is that poor contrast occurs between dissimilar tissues (i.e. blood and fat) making it difficult to characterize certain ovarian masses accurately.Ultrasound characterizes gynecologic pathology extremely well. Fibroids, endometriomas, dermoids, masses that are suspicious for malignancy, uterine anomalies, IUD complications, ectopic pregnancies, and endometrial pathology (with the help of transvaginal saline infusion sonography) are diagnoses that are detected with high accuracy. The following will give illustrations of the clinical utility of diagnostic gynecologic ultrasound for specific clinical conditions. AbstractAlthough ultrasound is the primary imaging modality for most gynecologic diagnoses and conditions, knowledge of other diagnostic imaging procedures is important to gynecologists, emergency room physici...

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Section: Pelvic Inflammatory Disease/ Tubo-ovarian Abscessmentioning

confidence: 99%

Imaging Modalities in Gynecology

Busse¹

2010

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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“…CT and MR scans are very rarely useful (LE 2b) [134][135][136][137]. However, DL is better than US (LE 2b) [123,128,130,133,138] and may lead to the modification of an incorrect preoperative diagnosis in up to 40 % of cases (LE 4) [124,128,130,139,140].…”

Section: Gynecologic Disordersmentioning

confidence: 99%

Laparoscopic approach to acute abdomen from the Consensus Development Conference of the Società Italiana di Chirurgia Endoscopica e nuove tecnologie (SICE), Associazione Chirurghi Ospedalieri Italiani (ACOI), Società Italiana di Chirurgia (SIC), Società Italiana di Chirurgia d’Urgenza e del Trauma (SICUT), Società Italiana di Chirurgia nell’Ospedalità Privata (SICOP), and the European Association for Endoscopic Surgery (EAES)

et al. 2012

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Background In January 2010, the SICE (Italian Society of Endoscopic Surgery), under the auspices of the EAES, decided to revisit the clinical recommendations for the role of laparoscopy in abdominal emergencies in adults, with the primary intent being to update the 2006 EAES indications and supplement the existing guidelines on specific diseases. Methods Other Italian surgical societies were invited into the Consensus to form a panel of 12 expert surgeons. In order to get a multidisciplinary panel, other stakeholders involved in abdominal emergencies were invited along with a patient's association.

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“…Given such a vast differential diagnosis, the key investigative tool for acute lower abdominal and pelvic pain is the ultrasound. [8][9][10][11][12][13][14][15] In the emergency department setting ultrasound is the best initial imaging modality for evaluation of pelvic pathology due to its low cost, easy accessibility, widespread availability and lack of ionizing radiation. 16 Additional investigations include the following: • CBC: To detect an elevated leukocytosis (nonspecific).…”

Section: Introductionmentioning

confidence: 99%

Role of Ultrasound in the Evaluation of Acute Pelvic Pain in Nonpregnant Reproductive Age Patients

N¹

2012

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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In an emergency setting pelvic ultrasound is the tool of choice for the evaluation of the patients presenting with acute pelvic pain. It has a high sensitivity and specificity for detection of pelvic pathology, low cost, widespread availability and lack of ionizing radiation. This article presents a variety of case scenarios regarding the nonpregnant female of reproductive age presenting with acute pelvic and lower abdominal pain. By using illustrative images, the reader will be able to differentiate between the most common causes of abdominal and/or pelvic pain and identify typical B-mode and color Doppler ultrasound findings and CT images that require immediate treatment, while minimizing the performance of unnecessary additional imaging and invasive procedures.

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Imaging of Acute Pelvic Pain

Cited by 71 publications

References 30 publications

Imaging Modalities in Gynecology

Imaging Modalities in Gynecology

Role of Ultrasound in the Evaluation of Acute Pelvic Pain in Nonpregnant Reproductive Age Patients

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