read this first: abdominal pain in ED

• abdominal aortic aneurysm (usually higher up than suprapubic though)
• UTI / cystitis
• acute urinary retention
• ulcerative colitis
• diverticulitis
• gynae causes:
  • miscarriage / abruption
  • labour
  • dysmenorrhoea
  • endometriosis
  • imperforate hymen with retained menses (haematocolpos) in pre-menarchal pubertal females

• consider urgent bedside US if > 50yrs and suspect AAA
• FWT urine to exclude UTI & pregnancy
• if palpable bladder or unable to pass urine consider bladder US in ED +/- urinary catheter
• if heavy PV bleed then Mx according to suspected cause eg. 10 days primolut 5-10mg tds for DUB;
• if pre-menarchal female aged 10-14yrs then consider US to excl. haematocolpos