REBEL Core Cast – Basics of EM – Lower Abdominal Pain

Take Home Points

  • Get a upreg on every female patient of child bearing age with lower abdominal pain – this is an ectopic pregnancy until proven otherwise
  • Always consider ovarian/testicular pathology for lower abdominal pain
  • Always have a chaperone when performing genitourinary physical exams
  • Ovarian cysts >5 cm are at high risk for torsion, consider torsion/detorsion in patients with intermittent pain – definitive diagnosis is in the OR
  • Watch for enlarged ovary on u/s – arterial flow can be preserved but venous congestion will cause the ovary to appear large – its still a torsion
  • Gonorrhea/Chlamydia treatment has changed! Azithromycin is no longer recommended by CDC. Give doxycycline and the higher dose ceftriaxone

REBEL Core Cast – Basics of EM – Lower Abdominal Pain

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James F. Martin, MD
Associate Clinical Professor – Rutgers RWJ
Monmouth Medical Center– RWJBarnabas
Long Branch, NJ

Post Peer Reviewed By: Anand Swaminathan, MD (Twitter: @EMSwami)

Cite this article as: Ellsworth Wright, "REBEL Core Cast – Basics of EM – Lower Abdominal Pain", REBEL EM blog, June 1, 2022. Available at:
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Ellsworth Wright

Emergency Physician at St. Joseph's Regional Medical Center

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