Abdominal pain is the most common presenting ED complaint. ED texts advocate speculum bimanual pelvic exam to differentiate pathology of abdominal versus pelvic etiology in women of childbearing age. However, the exam is invasive and requires significant ED resources. We hypothesize that routine pelvic exams of females complaining of abdominal pain without vaginal complaints in the ED does not alter clinical management. We performed a retrospective observational study of ED patients in an urban Level 1 trauma center for all non-pregnant women seen from January 2013 to July 2013, aged 18-50, with a chief complaint of isolated lower abdominal pain without vaginal pain or other vaginal complaints. 487 patients were included. Our data shows that, despite frequent utilization, pelvic exams do not significantly alter the patient’s diagnosis. We propose selectively performing the exam in those with risk factors.
Sharan, L.; Chien, J.; Maiers, T.; and Lau, WB, "Utility of Pelvic Examination in Lower Abdominal Pain without Vaginal Complaints" (2014). Sigma Xi Student Research Day. Paper 3.