الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Acute pelvic pain refers to pain of a duration ≤ 3 months. It is a major diagnostic challenge to primary care physicians. A diagnosis based solely on the history, physical examination and simple laboratory data is frequently inaccurate. Much of the morbidity and mortality associated with its different causes can be attributed to delay in establishing the correct diagnosis.
The most common urgent causes of acute pelvic pain regarding the gynecological causes encountered in our study are ectopic pregnancy, endometriosis, ovarian torsion, pelvic inflammatory disease, ruptured ovarian cyst and tubo-ovarian abscess; however, many other diagnoses in the differential may mimic these conditions.
Diagnostic imaging allows rapid and often precise diagnosis, leading to an optimal management, especially allowing efficient triaging of patients between medical or symptomatic treatment, gynecologic consultation or referral to surgery, and interventional radiology.
The aim of this study was to assess the role and usefulness of different imaging modalities in the evaluation of gynecologic causes of acute pelvic pain.
We included 30 patients complaining of acute pelvic pain due to gynecologic causes.
All patients under went full history taking and clinical examination, laboratory analysis of urine, white blood cell count and Beta human chorionic gonadotropin (B-HCG) blood level. Imaging evaluation included Ultrasound either pelvi-abdominal, transvaginal or both and further multi-detector CT or MRI whenever indicated and follow up of the patients (operative data, pathology, clinical &/or imaging follow up) whenever possible.
All patients presented with acute pelvic pain as well as other associated symptoms as follows: Four patients presented by fever, two patients complained of dysmenorrhea, two complained of urine retention, one complained of constipation and dyschezia, one complained of leukorrhoea, one of right iliac fossa tenderness and one complained of foul odour vaginal discharge.
Laboratory investigations were also done where pregnancy test was negative in 11 patients (36.7 %), positive in 4 patients (13.3 %) where 3 of those were diagnosed as ectopic pregnancy and 1 of which had heterotopic pregnancy and the 4th pregnant female was diagnosed with ovarian hyperstimulation syndrome. In the rest fifteen patients (50 %) pregnancy test was not done because they were either in the pre-pupertal period, virgins or within the puerperal period .
Ultrasound remains the primary modality by which complaints specific to the pelvis are evaluated. Ultrasound examinations have preceded all other imaging modalities when evaluating pelvic disorders, yet advances in technology and improved availability have led to increased use of computed tomography (CT) and magnetic resonance imaging (MRI) to evaluate women presenting to the emergency department with pelvic pain especially if ultrasound is insufficient to reach a d