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Adnexal mass evaluation in the emergency department
1Emergency Medicine Residency, San Antonio Uniformed Services Health Education Consortium, Brooke Army Medical Center/Wilford Hall Medical Center, Fort Sam Houston, Texas, USA.
Emergency Medicine Clinics of North America
|September 14, 2001
Summary
Managing abdominopelvic pain and adnexal masses in female emergency department patients requires a focused approach. A rapid history, physical exam, and targeted lab tests aid in diagnosis and disposition.
Area of Science:
- Emergency Medicine
- Gynecology
- Diagnostic Imaging
Background:
- Abdominopelvic pain and adnexal masses in female patients present diagnostic challenges in the emergency department.
- Stable vital signs do not exclude serious underlying pathology.
Purpose of the Study:
- To outline a systematic approach for the rapid evaluation and management of female patients with abdominopelvic pain and adnexal masses.
- To improve diagnostic accuracy and streamline consultation and disposition.
Main Methods:
- Problem-oriented history and physical examination focusing on age, menstrual history, and pelvic exam findings.
- Laboratory investigations including complete blood count (CBC) and human chorionic gonadotropin (HCG).
- Consideration of CA-125 levels and ultrasound imaging.
Main Results:
- A detailed differential diagnosis can be compiled through a targeted history and physical exam.
- Key laboratory and imaging studies provide crucial information for diagnosis.
- This integrated approach facilitates efficient consultation and patient disposition.
Conclusions:
- A structured, problem-oriented approach is effective for managing female patients with abdominopelvic pain and adnexal masses.
- Timely and appropriate diagnostic workup leads to effective consultation and disposition decisions.