Mittelschmerz
Related Subjects:Acute Cholecystitis
|Acute Appendicitis
|Chronic Peritonitis
|Abdominal Aortic Aneurysm
|Ectopic Pregnancy
|Acute Cholangitis
|Acute Abdominal Pain
|Penetrating Abdominal Trauma
|Acute Pancreatitis
|Acute Diverticulitis
📖 About
- ⚡ Mittelschmerz is German for "middle pain" and refers to pain occurring mid-cycle during ovulation.
- 🩺 This is one-sided, lower abdominal pain associated with the release of an egg from the ovary.
🧬 Aetiology
- 💥 The Graafian follicle ruptures approximately 10-14 days after the last menstrual period (LMP).
- 🩸 There may be some associated bleeding at the time of rupture.
- 📈 The pain coincides with a peak in plasma luteinizing hormone (LH) levels, triggering ovulation.
🩹 Clinical Features
- 👩 Most commonly seen in individuals aged 15-25 years.
- 🤲 Examination may reveal tenderness and guarding.
- ⚠️ Pain and tenderness are often found in the rectovaginal pouch.
🖥️ Investigations
- 🧪 Ultrasound (US) may show free fluid in the rectovaginal pouch, indicative of ovulation-related fluid leakage.
🔍 Differential Diagnosis
- 🚨 Ruptured ectopic pregnancy.
- 🔥 Appendicitis.
💊 Management
- 🛌 Conservative management is typically sufficient.
- 🔬 Laparoscopy may be considered as a precaution in certain cases.