Sonographic Evaluation of Acute Pelvic Pain

BACKGROUNDAcute pelvic pain can result from the gastrointestinal, gynaecological and/or urological systems.Ultrasound can be used as an initial imaging modality in the evaluation of acute pelvic pain. OBJECTIVETo evaluate the use of ultrasonography in acute pelvic pain, characterise the most common aetiologies and study the age and sex incidence in patients of acute pelvic pain. MATERIALS AND METHODSThe study was conducted on hundred patients in the Department of Radiodiagnosis and Imaging, Government Medical College, Amritsar, from August 2013 to October 2015.Patients presenting with acute pelvic pain from various emergency, outpatient and indoor departments were included in the study.Based on sonographic findings provisional diagnosis was made, which was confirmed by operative findings/therapeutic response/FNAC findings/Histopathological/Laboratory findings.All pregnant patients and trauma cases were excluded from the study. RESULTSThe age incidence of the cases in this study varied between 4 years to 56 years.The mean age of the patients in the study was 31 years; 23% cases were males and 77% cases were females in this study with the male-to-female ratio of 1:3.34.The appendix is most commonly involved in acute pelvic pain and is seen in 38% cases followed by Adnexal lesions in 36% cases, urinary system in 15% cases, small bowel in 8% cases, lymph nodes in 3% of cases.In Adnexal pathologies of acute pelvic pain, haemorrhagic ovarian cysts are most common, constituting 50% of Adnexal lesions in acute pelvic pain followed by PID in 41.7% and ovarian torsion in 8.3% of Adnexal lesions; 15% of pathologies related to urinary system, 8% with small bowel obstruction and 3% patients with mesenteric adenitis. CONCLUSIONSUltrasound is a very good modality for acute pelvic pain, as it can easily diagnose and characterise the causes of pelvic pain.The wide availability, radiation free and cost effectiveness makes it a first line investigation in acute pelvic pain.