AB264. Emergency department requests for gynaecology scans

Background: Gynaecology services at Tallaght Hospital are overwhelmed with ultrasound scan requests from the emergency department (ED). The primary aim of this research was to look at the presenting features and histories of women attending the ED for whom a gynaecology ultrasound was requested, and the subsequent outcome of these scans.

Methods: Data was collected at the time of initial patient presentation and post ultrasound.

Results: Thirty-seven cases were studied with a mean age of 33.2 years. Nineteen patients were reviewed by gynaecology and 17 by ED doctors who sought over the phone advice from gynaecology. Right iliac fossa pain was the most common presenting complaint (n=14) followed by left iliac fossa pain (n=10). Nine patients had a soft non-tender abdomen whilst others had mild or moderate abdominal pain (n=13; n=6). None had significant findings on vaginal examination but nine reported a history of ovarian cysts. Twenty-one patients had a normal transvaginal scan. Two patients were referred to surgeons with suspected femoral or inguinal hernias, and one with constipation. One patient had a suspected ruptured ectopic pregnancy on scan and was taken to theater. Most patients were discharged to GP care (n=24) and four required gynaecology follow-up.

Conclusions: Most gynaecology scans performed following ED presentations with abdominal pain are normal. Data is required on repeat presentations and management of ongoing abdominal pain. A larger sample is needed prior to developing a pathway or triage system for gynaecology scans.

Keywords: Ultrasound; gynaecology; abdominal; pelvic; pain