19-year-old woman with right iliac fossa pain
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Tag Year: Year
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Tag specialty:
Reproduction
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You are a registrar working in A&E.
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Hannah, a 19-year-old woman, presents to A&E with what she describes as excruciating pain in her
right iliac fossa.
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She says she has her period at the moment, but until now hasn’t had a period for a couple months.
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Hannah has never had pain like this before. The pain started two days ago. It was intermittent
at first, and worse when she moved. She describes it as a sharp, stabbing pain. It got worse
and now she says it is unbearable. Nothing makes it better, and it does not radiate anywhere.
She has had no gastrointestinal symptoms.
She is sexually active and there is a possibility she might be pregnant. She says she uses
barrier contraception only. She has never had an STI check.
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Pregnancy test is positive.
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Ultrasound scan confirms ectopic pregnancy.
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Hannah gets an emergency salpingectomy. She makes a good recovery and
is discharged.
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Ectopic pregnancy and miscarriage: diagnosis and initial management NICE guidelines
https://www.nice.org.uk/guidance/ng126
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Diagnosis and Management of Ectopic Pregnancy (Green-top Guideline No. 21) RCOG
https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg21/
A 19-year-old woman, Hannah, presents with excruciating right iliac fossa pain and a positive pregnancy test. Imaging confirms an ectopic pregnancy. Learn about the diagnosis, treatment, and risk factors for ectopic pregnancies in young women.
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Presentation Transcript
19-year-old woman with right iliac fossa pain Sarah Perrott, Created 12/08/21 Tag Year: Year 3 Tag specialty: Reproduction
Introduction You are a registrar working in A&E. Hannah, a 19-year-old woman, presents to A&E with what she describes as excruciating pain in her right iliac fossa. She says she has her period at the moment, but until now hasn t had a period for a couple months.
Question 1 What are some causes of right iliac fossa pain in a female of this age?
Question 2 What questions would you ask?
Hannah has never had pain like this before. The pain started two days ago. It was intermittent at first, and worse when she moved. She describes it as a sharp, stabbing pain. It got worse and now she says it is unbearable. Nothing makes it better, and it does not radiate anywhere. She has had no gastrointestinal symptoms. She is sexually active and there is a possibility she might be pregnant. She says she uses barrier contraception only. She has never had an STI check. Question 3 What immediate investigations would you arrange?
Pregnancy test is positive. Question 4 Give two possible diagnoses.
Ultrasound scan confirms ectopic pregnancy. Question 5 What is the definition of ectopic pregnancy?
Question 6 How should Hannah be managed?
Hannah gets an emergency salpingectomy. She makes a good recovery and is discharged. Question 7 What are the risk factors for ectopic pregnancy?
Question 8 What is the most common site of an ectopic pregnancy?
Useful resources Ectopic pregnancy and miscarriage: diagnosis and initial management NICE guidelines https://www.nice.org.uk/guidance/ng126 Diagnosis and Management of Ectopic Pregnancy (Green-top Guideline No. 21) RCOG https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg21/
