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Pelvic pain in young girls

An ultrasound examination is usually one of the first investigations requested because it is non-invasive. 

We put the ultrasound transducer on the lower abdomen and if the bladder is reasonably full then good images of the bladder, uterus, vagina and ovaries are easily achieved. We also check higher up in the abdomen for evidence of appendicitis or mesenteric adenitis. 

There are many different causes of pelvic pain but ultrasound examination can usually distinguish which organ it arises from and what the likely pathology is. 

Ovarian causes include:

  • Luteal cysts from where ovulation has occurred
  • Follicular cysts from the developing ovarian follicle
  • Dermoid cysts which can twist. They are always benign
Uterine causes include: 

  • Haematometra or 
  • Haematocolpos where menstrual blood has distended the uterus and or vagina because there is a blockage to flow
Other causes include: 
  • Appendicitis
  • Mesenteric adenitis where lymph nodes in your abdomen become enlarged from a viral infection
Gynaecological infections and cancer are very rare in this age-group.

Appendicitis in a young girl