Gynaecological causes of abdominal pain

Women presenting with pain are likely to present to a variety of clinicians including general surgeons. This article addresses causes of abdominal pain in pregnancy such as miscarriage, ectopic pregnancy, fibroids and urinary tract infection. In the non-pregnant female, cyclical causes of pain include primary dysmenorrhoea, endometriosis and mittelschmerz; and non-cyclical causes include pelvic inflammatory disease, ovarian cyst accidents and adhesions. An ovarian cyst accident occurs when an ovarian cyst undergoes torsion, bleeds internally or ruptures. Timely diagnosis is prudent in order to avoid ovarian infarction and hence loss of ovarian tissue, especially in a young woman. Pelvic inflammatory disease is the reason for 1 in 60 visits to GPs by women under 45 years. It has long-term consequences which include chronic pelvic pain and infertility making timely management crucial. In the UK nearly 12,000 ectopic pregnancies are diagnosed annually, giving a prevalence of 1.1%. In the period 2006–8 there were six deaths resulting from ectopic pregnancy. This article gives a brief overview of the causes and treatment of abdominal pain in women presenting with a gynaecological aetiology.