Preliminary management of acute onset right sided abdominal pain in women

A 23 year old woman presents to the emergency department with a 24 hour history of abdominal pain that is worse in her right lower quadrant. She has had one episode of loose stool and feels nauseated. She has a pulse rate of 97 beats/min and a blood pressure of 123/67 mm Hg. Her temperature is 37.7°C.

When assessing a patient, early recognition of pathology is key to initiating appropriate management and improving patient outcome. Emergency doctors and primary care practitioners have to decide when to refer and which specialist team to refer to. This can be daunting when several potentially life threatening differential diagnoses need consideration, and delay in treatment or referral to the incorrect specialist team can negatively affect patient care. This article explores the case of a young woman with acute abdominal pain and helps to formulate an approach that ensures thorough assessment and referral, and timely decision making.

The article refers to “young women,” to reflect the clinical vignette. The guidance applies to any patient with childbearing potential—ie, those of reproductive age, with female reproductive organs.