[42F] With severe lower left abdominal pain and back pain post-coitus
Patient Description
A 42-year-old female presents with severe sharp and crampy pain in the lower left abdomen, radiating to the lower hip area in the back, which began suddenly during sexual intercourse. The pain is described as throbbing and sharp and is somewhat alleviated by assuming the fetal position. The patient also reports associated nausea and constipation but denies fever, chills, abnormal vaginal discharge, or irregular menstrual bleeding. The patient has a history of tubal ligation but is unsure of any gynecological conditions such as endometriosis, ovarian cysts, or pelvic inflammatory disease (PID).
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Arora's Assessment
What might be happening
Based on the information you’ve provided, there are several potential causes for your symptoms, some of which are serious and require immediate medical attention:
- Ectopic Pregnancy: Although you have had a tubal ligation, there is still a small risk of ectopic pregnancy, where a fertilized egg implants outside the uterus. This can cause severe abdominal pain and is a medical emergency.
- Ovarian Cyst Rupture: A ruptured ovarian cyst can cause sudden, severe abdominal pain and may radiate to the back. This can also be accompanied by nausea and vomiting.
- Pelvic Inflammatory Disease (PID): This is an infection of the female reproductive organs that can cause severe abdominal pain, especially after sex. It can also cause nausea and changes in bowel movements.
- Kidney Stones: Sharp, crampy pain that radiates to the back could be due to kidney stones, which can also cause nausea and vomiting.
- Appendicitis: Although less likely given the location of your pain, appendicitis can cause severe abdominal pain that may radiate to the back and is often accompanied by nausea and vomiting.
What you can do
Given the severity and sudden onset of your symptoms, it is crucial to seek immediate medical attention. Here are the steps you should take:
- Go to the Emergency Room: You should go to the nearest emergency room as soon as possible. If you are unable to get there yourself, call 911 or have someone drive you.
- Avoid Eating or Drinking: Until you are evaluated by a healthcare professional, avoid eating or drinking anything, as this could complicate potential treatments.
- Stay Calm and Rest: Try to stay as calm as possible and rest in a comfortable position, such as the fetal position, until help arrives.
Please remember that while I can provide information based on your symptoms, I am not a doctor. It is essential to seek care from a real health professional to receive a formal diagnosis and appropriate treatment.
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4 mo ago