Last reviewed: August 2020
Last updated: November  2019

Summary

Definition

History and exam

Key diagnostic factors

  • abdominal pain
  • nausea, vomiting, or diarrhoea
  • abdominal/pelvic tenderness
  • palpable adnexal mass

Other diagnostic factors

  • feeding intolerance, vomiting, abdominal distension, and fussiness (neonates)
  • strenuous exercise
  • peritoneal signs
  • cervical motion tenderness
  • fever

Risk factors

  • ovarian neoplasm
  • ovarian cyst
  • para-ovarian cyst
  • hydrosalpinx
  • pregnancy
  • infertility treatment
  • strenuous exercise
  • sudden increased abdominal pressure

Diagnostic investigations

1st investigations to order

  • FBC
  • pregnancy test
  • transvaginal ultrasound with Doppler flow
  • abdominal ultrasound
  • genetic probe or cervical culture
  • urinalysis
  • surgical visualisation
More 1st investigations to order

Treatment algorithm

Contributors

Professor

Department of Obstetrics and Gynecology

Northeast Ohio Medical University

Aultman Health Foundation OB/GYN Residency

Canton

OH

Disclosures

MPH declares that he has no competing interests.

Dr Michael P. Hopkins would like to gratefully acknowledge Dr Jay R. Patibandla, Dr John C. Nulsen, and Dr Vanessa N. Weitzman, the previous contributors to this topic.

Peer reviewersVIEW ALL

Consultant Gynaecologist

University Department of Obstetrics and Gynaecology

Royal Free Hospital

London

UK

Disclosures

AM declares that he has no competing interests.

Professor

Department of Obstetrics

Gynecology and Reproductive Sciences

Vice Chairman

Reproductive Sciences

Director

Division of Reproductive Endocrinology and Infertility

University of Pittsburgh

Pittsburgh

PA

Disclosures

JS declares that he has no competing interests.

Associate Professor and Chief

General Division of Obstetrics and Gynecology

University of Utah School of Medicine

Salt Lake City

UT

Disclosures

HS has been reimbursed for attending and participating in conferences on pelvic varicosity pain syndrome by Cook Inc.

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