Take Home Points
- Get a upreg on every female patient of child bearing age with lower abdominal pain – this is an ectopic pregnancy until proven otherwise
- Always consider ovarian/testicular pathology for lower abdominal pain
- Always have a chaperone when performing genitourinary physical exams
- Ovarian cysts >5 cm are at high risk for torsion, consider torsion/detorsion in patients with intermittent pain – definitive diagnosis is in the OR
- Watch for enlarged ovary on u/s – arterial flow can be preserved but venous congestion will cause the ovary to appear large – its still a torsion
- Gonorrhea/Chlamydia treatment has changed! Azithromycin is no longer recommended by CDC. Give doxycycline and the higher dose ceftriaxone
REBEL Core Cast – Basics of EM – Lower Abdominal Pain
Click here for Direct Download of the Podcast
Co-Host
James F. Martin, MD
Associate Clinical Professor – Rutgers RWJ
Monmouth Medical Center– RWJBarnabas
Long Branch, NJ
Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami)
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