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Franco PN, García-Baizán A, Aymerich M, Maino C, Frade-Santos S, Ippolito D, Otero-García M. Gynaecological Causes of Acute Pelvic Pain: Common and Not-So-Common Imaging Findings. Life (Basel) 2023; 13:2025. [PMID: 37895407 PMCID: PMC10608316 DOI: 10.3390/life13102025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/06/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
In female patients, acute pelvic pain can be caused by gynaecological, gastrointestinal, and urinary tract pathologies. Due to the variety of diagnostic possibilities, the correct assessment of these patients may be challenging. The most frequent gynaecological causes of acute pelvic pain in non-pregnant women are pelvic inflammatory disease, ruptured ovarian cysts, ovarian torsion, and degeneration or torsion of uterine leiomyomas. On the other hand, spontaneous abortion, ectopic pregnancy, and placental disorders are the most frequent gynaecological entities to cause acute pelvic pain in pregnant patients. Ultrasound (US) is usually the first-line diagnostic technique because of its sensitivity across most common aetiologies and its lack of radiation exposure. Computed tomography (CT) may be performed if ultrasound findings are equivocal or if a gynaecologic disease is not initially suspected. Magnetic resonance imaging (MRI) is an extremely useful second-line technique for further characterisation after US or CT. This pictorial review aims to review the spectrum of gynaecological entities that may manifest as acute pelvic pain in the emergency department and to describe the imaging findings of these gynaecological conditions obtained with different imaging techniques.
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Affiliation(s)
- Paolo Niccolò Franco
- Department of Radiology, Hospital Universitario de Vigo, Carretera Clara Campoamor 341, 36312 Vigo, Spain; (A.G.-B.); (S.F.-S.); (M.O.-G.)
- Department of Diagnostic Radiology, IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (C.M.); (D.I.)
| | - Alejandra García-Baizán
- Department of Radiology, Hospital Universitario de Vigo, Carretera Clara Campoamor 341, 36312 Vigo, Spain; (A.G.-B.); (S.F.-S.); (M.O.-G.)
- Diagnostic Imaging Research Group, Radiology Department, Galicia Sur Health Research Institute (IIS Galicia Sur), Galician Health Service (SERGAS)-University of Vigo (UVIGO), 36213 Vigo, Spain;
| | - María Aymerich
- Diagnostic Imaging Research Group, Radiology Department, Galicia Sur Health Research Institute (IIS Galicia Sur), Galician Health Service (SERGAS)-University of Vigo (UVIGO), 36213 Vigo, Spain;
| | - Cesare Maino
- Department of Diagnostic Radiology, IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (C.M.); (D.I.)
| | - Sofia Frade-Santos
- Department of Radiology, Hospital Universitario de Vigo, Carretera Clara Campoamor 341, 36312 Vigo, Spain; (A.G.-B.); (S.F.-S.); (M.O.-G.)
- Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG), Rua Prof. Lima Basto, 1099-023 Lisbon, Portugal
| | - Davide Ippolito
- Department of Diagnostic Radiology, IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900 Monza, Italy; (C.M.); (D.I.)
- School of Medicine, University of Milano Bicocca, Via Cadore 33, 20090 Monza, Italy
| | - Milagros Otero-García
- Department of Radiology, Hospital Universitario de Vigo, Carretera Clara Campoamor 341, 36312 Vigo, Spain; (A.G.-B.); (S.F.-S.); (M.O.-G.)
- Diagnostic Imaging Research Group, Radiology Department, Galicia Sur Health Research Institute (IIS Galicia Sur), Galician Health Service (SERGAS)-University of Vigo (UVIGO), 36213 Vigo, Spain;
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Budha B, Jha K, Poudel D, Pokharel S, Aryal S, Bajracharya S, Joshi B, Ghimire A. Primary omental ectopic pregnancy: A rare case report. Clin Case Rep 2023; 11:e8063. [PMID: 37854260 PMCID: PMC10580687 DOI: 10.1002/ccr3.8063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/27/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
Primary abdominal pregnancy is the rarest form of ectopic pregnancy in which the fertilized ovum is directly implanted into peritoneal cavity. This condition poses significantly high risk of maternal morbidity and mortality. Here, we present a case of 5 weeks of primary omental pregnancy managed by laparotomy.
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Affiliation(s)
- Bishal Budha
- Maharajgunj Medical Campus, Institute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Kritika Jha
- Department of Obstetrics and Gynaecology, Maharajgunj Medical CampusTribhuvan UniversityMaharajgunjNepal
| | - Dhiraj Poudel
- Maharajgunj Medical Campus, Institute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Saroj Pokharel
- Maharajgunj Medical Campus, Institute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Suraj Aryal
- Maharajgunj Medical Campus, Institute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Satish Bajracharya
- Maharajgunj Medical Campus, Institute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Bishweshwar Joshi
- Maharajgunj Medical Campus, Institute of MedicineTribhuvan UniversityMaharajgunjNepal
| | - Asmita Ghimire
- Department of Obstetrics and Gynaecology, Maharajgunj Medical CampusTribhuvan UniversityMaharajgunjNepal
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Legesse TK, Ayana BA, Issa SA. Surviving Fetus from a Full Term Abdominal Pregnancy. Int Med Case Rep J 2023; 16:173-178. [PMID: 36950324 PMCID: PMC10025137 DOI: 10.2147/imcrj.s403180] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023] Open
Abstract
Background Abdominal pregnancy refers to a rare form of ectopic pregnancy that has been implanted in the peritoneal cavity. Clinical suspicion combined with ultrasound is important for early diagnosis. A surviving fetus from an abdominal pregnancy is extremely rare. Case Presentation Herein we report on a case of advanced abdominal pregnancy in a Gravida-III Abortion-II mother who presented with worsening abdominal pain of 1 week duration associated with fetal movement and managed successfully with an outcome of a live neonate and no maternal complication. Conclusion A live neonate from term abdominal pregnancy is a rare occurrence. Early diagnosis of abdominal pregnancy is crucial to avoid potentially catastrophic maternal complications even though our patient, fortunately, has a smooth postoperative course. A high level of suspicion combined with ultrasound is helpful in reaching a diagnosis. Skill advancement for radiologists and non-radiology professionals involved in obstetric ultrasound is recommended to avoid misdiagnosis, as in our case. Careful post-operative evaluation is important to look for maternal and fetal complications.
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Affiliation(s)
- Tesfaye Kebede Legesse
- Department of Radiology, Addis Ababa University, College of Health Science, Addis Ababa, Ethiopia
- Correspondence: Tesfaye Kebede Legesse, Tel +251911405854, Email
| | - Birhanu Abera Ayana
- Department of Obstetrics and Gynecology, Addis Ababa University, College of Health Science, Addis Ababa, Ethiopia
| | - Semira Abrar Issa
- Department of Radiology, Addis Ababa University, College of Health Science, Addis Ababa, Ethiopia
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Gure T, Sultan S, Alishum R, Ali A, Dibaba B, Usmael I, Tsegaye S. Term Abdominal Pregnancy with Live Baby: Case Report from Hiwot Fana Specialized University Hospital, Eastern Ethiopia. Int Med Case Rep J 2021; 14:689-695. [PMID: 34616185 PMCID: PMC8488043 DOI: 10.2147/imcrj.s331195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/18/2021] [Indexed: 12/03/2022] Open
Abstract
Purpose To present a rare case of term abdominal pregnancy with live baby. Observation A 30-year-old gravida VI para V, all alive, woman who did not remember her last menstrual period but was stated amenorrheic for 9 months visited Hiwot Fana Specialized University Hospital (HFSUH) with abdominal pain of two weeks duration. The woman was diagnosed with a term abdominal pregnancy and underwent a laparotomy. The outcome of treatment was a 3200 gm healthy male baby and a total abdominal hysterectomy was done. Conclusion and Importance Term abdominal pregnancy is an extremely rare type of ectopic pregnancy that can cause diagnostic challenges and leads to life threatening conditions both before and after diagnosis because of the rupture of major blood vessels.
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Affiliation(s)
- Tadesse Gure
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Semir Sultan
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Rehama Alishum
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Abdek Ali
- Department of Gynecology and Obstetrics, Jigjiga University, Jigjiga, Ethiopia
| | - Bayissa Dibaba
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Ibsa Usmael
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
| | - Setegn Tsegaye
- Department of Gynecology and Obstetrics, Haramaya University, Harar, Ethiopia
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