Unexpected Findings during Evaluation of Acute Pelvic Pain with Transvaginal Sonography

SONOSIM SUMMARY: This article presents several interesting case studies in which diagnostic transvaginal ultrasonography performed for evaluation of pelvic pain revealed nongynecologic etiologies. Non-gynecologic findings included obstructive ureterolithiasis, an ectopic kidney, gastrointestinal disorders (such as bowel obstruction and acute appendicitis), and deep vein thrombus of the iliac vein. The article reinforces that transvaginal ultrasonography is a powerful modality for evaluating pelvic pathology and that surrounding structures should not be neglected when performing this scan.

Ohngemach DJ, Esterson YB, Rahman N, et al. Unexpected findings during evaluation of acute pelvic pain with transvaginal sonography. J Ultrasound Med. 2016 Dec;35(12):2687-2696.

Abstract

Transvaginal sonography is the first-line imaging modality used to evaluate acute female pelvic pain in the emergency setting because of its accessibility, lack of ionizing radiation, and excellent ability to identify reproductive tract disorders. Although the intent of transvaginal sonography is to evaluate the reproductive organs, imaging of adjacent pelvic structures is an important part of every transvaginal sonographic examination. Gastrointestinal, urologic, and vascular disorders incidentally scanned on transvaginal sonography may explain the pain for which the examination is being performed. In such cases, transvaginal sonography may play an important role in the diagnostic process if the clinician is aware of the transvaginal sonographic appearance of these entities.

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SonoSim Keywords: Ultrasound Education, Ultrasound Training, Pelvic Ultrasound, OG-GYN Ultrasonography