The diagnosis and management of abdominal and pelvic pain in women can be challenging. While some diagnoses are obvious or nearly so, others are elusive. While the diagnosis is most often made on the basis of clinical history, the relative certainty of diagnosis is often strengthened through the use of laboratory, imaging studies, and the physical examination.

I’m going to provide you with some general guidelines and a structure for evaluating patients with abdominal or pelvic pain, but I must caution you:

• These insights do not apply well to an acutely traumatized patient (a vehicular accident victim, for example).
• They also don’t apply well to post-op patients or postpartum patients, where the issues can be quite different.
• In this discussion, I am presuming that there is only one thing wrong with the patient. Usually that’s the case, but sometimes it’s not.

A structured approach usually works best for for those learning these skills, later, with more experience, you may skip over some parts of this process. The process involves asking a series of questions (history), examining the patient with an abdominal exam and pelvic exam (exam), obtaining a set of vital signs, and some basic laboratory tests. While learning these skills, you may find the Abdominal and Pelvic Pain Patient Evaluation Form useful as a teaching aid.

Abdominal Pain General Guidance for Women in Military Settings

• General Guidance

Clinical Approach

• Patient History
• Patient Physical Exam
• Pelvic Exam
• Lab and Imaging
• Clinical Evaluation Form

OBGYN Specific

• Threatened Abortion
• Ectopic Pregnancy
• Placental Abruption
• IUD Problems
• Ovarian Cyst
• Painful Menstrual Flows
• Midcycle Pain
• Functional Bowel Syndrome
• Gastroenteritis
• Diverticular Disease
• PID – Pelvic Inflammatory Disease
• Endometriosis
• Appendicitis
• Bowel Obstruction
• Degenerating Fibroid
• Infected or Rejected IUD
• Cystitis
• Pyelonephritis