Approach to acute pelvic pain (GYN) Quiz: Ace Your Exams
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A 38-year-old woman presents to the emergency department for evaluation of severe left-sided pelvic pain that started suddenly two hours ago while she was at the gym. She has had nausea and vomiting since the onset of the pain. She is not sexually active and has never been pregnant. Temperature is 37.0°C (98.6°F), pulse is 122/min, respiratory rate is 20/min, blood pressure is 142/84 mmHg, and oxygen saturation is 98% on room air. On examination, she appears uncomfortable due to pain. Abdominal examination reveals moderate tenderness in the left lower quadrant. Serum hCG is negative. Ultrasound reveals a left ovary that is 5.5 cm in size with a twisted pedicle and diminished blood flow. Which of the following, if present, would be the greatest risk factor for this patient’s diagnosis?
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