PELVIC PAIN is a topic covered in the Harrison's Manual of Medicine.

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Etiology

Pelvic pain may be associated with normal or abnormal menstrual cycles and may originate in the pelvis or be referred from another region of the body. A high index of suspicion must be entertained for extrapelvic disorders that refer to the pelvis, such as appendicitis, diverticulitis, cholecystitis, intestinal obstruction, and urinary tract infections. A thorough history including the type, location, radiation, and status with respect to increasing or decreasing severity can help to identify the cause of acute pelvic pain. Associations with vaginal bleeding, sexual activity, defecation, urination, movement, or eating should be sought. Determination of whether the pain is acute versus chronic, constant versus spasmodic, and cyclic versus noncyclic will direct further investigation (Table 175-1).

TABLE 175-1: CAUSES OF PELVIC PAIN
 AcuteChronic
Cyclic pelvic pain 

Premenstrual symptoms

Mittelschmerz

Dysmenorrhea

Endometriosis

Noncyclic pelvic pain

Pelvic inflammatory disease

Ruptured or hemorrhagic ovarian cyst or ovarian torsion

Ectopic pregnancy

Endometritis

Acute growth or degeneration of uterine myoma

Pelvic congestion syndrome

Adhesions and retroversion of the uterus

Pelvic malignancy

Vulvodynia

Chronic pelvic inflammatory disease

History of sexual abuse

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Citation

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TY - ELEC T1 - PELVIC PAIN ID - 623431 Y1 - 2017 PB - Harrison's Manual of Medicine UR - https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623431/all/PELVIC_PAIN ER -