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Cute pelvic pain is a common presenting com-plaint in women. The diagnosis of pelvic pain in women can be challenging because many symp-toms and signs are insensitive and unspecific. Prompt diagnosis and effective management pre-vent complications and may help preserve fertility . | 5 Acute Pelvic Pain in a Limited-resource Setting Abubakar Danladi INTRODUCTION Acute pelvic pain is a common presenting complaint in women. The diagnosis of pelvic pain in women can be challenging because many symptoms and signs are insensitive and unspecific1. Prompt diagnosis and effective management prevent complications and may help preserve fertility2. Definition and epidemiology The definition of acute pelvic pain is arbitrary often the duration is only a few hours but it can be days. It usually presents with a sudden onset but may be insidious and the pain increasing with time. Generally any pain in the lower abdomen or pelvis lasting less than 3 months is considered acute pelvic pain1 3. Incidence The incidence of the different etiologies varies and is difficult to estimate. It is dependent on several factors e.g. prevalence of contributory factors of the different etiologies health-seeking behavior availability of diagnostic facilities different medical practice the distance to medical care and the age profile of the patient in a certain area3. Pathophysiology The pathophysiologies are influenced by the different etiological factors and are mediated via the pain pathway along the pelvic innervations. Distinguishing pain arising from the genital organs from that of gastrointestinal origin is often difficult due to the shared visceral innervations of the uterus cervix and adnexa and gastrointestinal structures i.e. ileum sigmoid colon and rectum as pain signals travel through the same sympathetic nerves to the spinal cord segments T10 via L1. Diffuse pain should alert to the possibility of peritonitis4. Acute pain due to ischemia or viscus injury such as in ovarian torsion or intestinal obstruction is accompanied by autonomic reflex responses such as nausea vomiting restlessness and sweating5. The suggested causes of pain in endometriosis include peritoneal inflammation activation of nociceptors and tissue damage and nerve irritation from deep .
