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DIFFERENTIAL DIAGNOSIS OF COMMON GYNECOLOGICAL COMPLAINTS Part 02

DIFFERENTIAL DIAGNOSIS OF COMMON GYNECOLOGICAL COMPLAINTS

PELVIC MASS


Uterus, Asymmetrical

 

  1. leiomyomata
  2. leiomyosarcoma


Uterus, Symmetrical

 

  1. pregnancy
  2. adenomyosis
  3. endometrial ca


Adnexal, Ovarian

 

  1. corpus luteum cyst
  2. follicular cyst
  3. theca lutein cyst
  4. endometrioma
  5. inflammatory cyst (tubo-ovarian abscess)
  6. luteoma of pregnancy
  7. polycystic ovary
  8. benign neoplasms  :  dermoid cyst (most common)
  9. malignant neoplasms  :  granulosa cell tumour (most common)

 

Adnexal, Non-ovarian

     

Gynecological

 

  1. ectopic pregnancy
  2. pelvic adhesions
  3. paratubal cysts
  4. pyosalpinx/hydrosalpinx
  5. leiomyomata or fibroids
  6. primary fallopian tube neoplasms

 

Gastrointestinal

 

  1. appendiceal abscess
  2. diverticular abscess
  3. diverticulosis, diverticulitis
  4. carcinoma of rectum/colon

 

Genitourinary

  1. distended bladder
  2. pelvic kidney
  3. carcinoma of the bladder


DYSPAREUNIA

 

  1. atrophic vaginitis
  2. chemical vaginitis
  3. lichen sclerosis Candida vulvovaginitis 
  4. Trichomonas vaginitis
  5. acute or chronic PID
  6. endometriosis
  7. fibroids 
  8. adenomyosis
  9. congenital abnormalities of vagina  e.g. septate vagina
  10. retroverted, retroflexed uterus may cause dyspareunia
  11. ovarian cysts/tumours
  12. symptomatic retroverted uterus
  13. psychological trauma
  14. vaginismus
  15. vulvodynia

PELVIC PAIN


Acute Pelvic Pain

 

Gynecological causes

  1. ectopic pregnancy
  2. abortion - missed, septic, etc...
  3. ruptured ovarian cyst
  4. torsion of ovary or tube
  5. hemorrhage into ovarian cyst, neoplasm
  6. degeneration of fibroid
  7. torsion of pedunculated fibroid
  8. acute PID
  9. mittelschmertz (ovulation pain as follicle ruptures into peritoneal space)

 

Non-gynecological causes

  1. appendicitis
  2. UTI - cystitis, pyelonephritis
  3. renal colic
  4. mesenteric adenitis
  5. diverticulitis
  6. inflammatory bowel disease

Chronic Pelvic Pain 

 

  • refers to pain of greater than 6 months duration

 

Gynecological causes of CPP

  1. chronic PID
  2. endometriosis
  3. adenomyosis
  4. invasive cervical ca (late)
  5. leiomyomata
  6. uterine prolapse
  7. adhesions
  8. cyclic pelvic pain
    • primary dysmenorrhea
    • secondary dysmenorrhea
  9. ovarian remnant syndrome
  10. pelvic congestion syndrome
  11. ovarian cyst

 

Non-gynecological causes

  1. referred pain
  2. urinary retention
  3. urethral syndrome
  4. penetrating neoplasms of GI tract
  5. irritable bowel syndrome
  6. partial bowel obstruction
  7. inflammatory bowel disease
  8. diverticulitis
  9. hernia formation
  10. nerve entrapment
  11. constipation
  12. psychological trauma
    • 20% of CPP is due to history of previous sexual abuse/assault
DIFFERENTIAL DIAGNOSIS OF COMMON GYNECOLOGICAL COMPLAINTS Part 02 DIFFERENTIAL DIAGNOSIS OF COMMON GYNECOLOGICAL COMPLAINTS Part 02 Reviewed by Radiology Madeeasy on August 21, 2010 Rating: 5
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