Upper genital tract infection should be suspected in women with lower abdominal pain (see Upper genital tract infections).
Gynaecological examination should be routinely performed:
– Inspection of the vulva, speculum examination: check for purulent discharge or inflammation,
and
– Abdominal exam and bimanual pelvic exam: check for pain on mobilising the cervix.

Case management

* Look for another cause (in particular, gastrointestinal or urinary pathology).
** Look for a pregnancy related pathology (threatened abortion, extra-uterine pregnancy) or a complication (peritonitis, pelvic abscess).