Pelvic hematoma after intercourse while on chronic anticoagulation

A 41-year-old anticoagulated woman presented with increasing pelvic pain that had begun two days prior during intercourse. An ultrasound and computerized tomographic (CT) scan confirmed the diagnosis of pelvic hematoma. The hematoma resolved spontaneously with normalization of clotting studies. The emergency physician should consider this rare cause of pelvic pain in selected anticoagulated patients. The need for a thorough history in emergency patients is emphasized, as well as the value of ultrasound and CT scan in the diagnosis of this disorder.