Emergency Department Evaluation of Acute Pelvic Pain in the Adolescent Female

Adolescent females presenting to the emergency department (ED) with acute pelvic pain may have diagnoses with significant morbidity and in some cases, mortality. An adolescent female with a complaint of acute pelvic pain can create a challenging clinical situation for busy ED providers. Differentiating between acute and chronic pain, and determining gynecologic vs other origins is an important first step. A thorough knowledge of adolescent development and the legal requirements of confidential care are helpful in sorting through these complicated complaints. Assessing for sexual activity and risk taking, pregnancy, and other sexual health components is critical to a thorough assessment and accurate diagnostic plan. Using an organ-specific approach to the reproductive system, this article will focus on urgent and sometimes life-threatening gynecologic causes of acute pelvic pain in the adolescent female in the context of an ED visit.