Upper Abdominal and Pelvic Scan Feature

1. What's causing your tummy pains? Most women will suffer stomach pains at some point and it's usually nothing more serious than menstrual period cramps, indigestion or a tummy upset. How can you tell if your tummy pain is serious? Often you can't - you'll need the expertise of your doctor who has been trained to detect 'red flag' symptoms that need more urgent investigation. To do this, they'll ask you questions about when your symptoms started, whether the pain is constant or intermittent, if it radiates to another area, and if it's worsened by movement or in a particular part of your abdomen. How an ultrasound scan can help An upper abdominal and pelvic scan combined with other tests will be able to reveal the possible causes of abdominal pain including: gynaecological conditions, ectopic pregnancy,gallstones, duodenal ulcers, kidney stones and liver problems.  This type of women's upper abdominal and pelvic scan, which is available privately from Ultrasound Direct, will examine the gall bladder, bile ducts and pancreas  Liver  Both kidneys, spleen and central blood vessels  Uterus  Lining of the womb  Ovaries  Pelvic area You'll be asked to fast for eight hours before the scan and only drink clear fluids (black tea or coffee is fine) so your sonographer can get a clearer view. Gynaecological causes of abdominal pain These can include ovarian cysts, polycystic ovarian syndrome, fibroidspelvic inflammatory disease and ectopic pregnancy.If your symptoms are suggestive of these conditions your scan may be done transvaginally. Ovarian cysts are fluid-filled sacs that form on the ovaries. They don't usually cause any symptoms unless they grow large or rupture and then cause a dull, heavy ache or a sudden and sharp pain, and can be diagnosed with an ultrasound scan. Most disappear on their own, but may need monitoring with a follow-up scan. Larger cysts can be a sign of ovarian cancer and may need to be removed surgically.i Polycystic Ovary Syndrome (PCOS) is a condition, which can cause weight gain, irregular periods, enlargement of the ovaries and development of multiple cysts on the ovaries. It can be diagnosed with an ultrasound scan and blood tests to check for hormonal problems. PCOS can lead to difficulties getting pregnant, but can be treated with medication and diet/lifestyle changes.ii Fibroids are muscular, benign growths in the wall of the uterus and may be diagnosed with a pelvic examination and imaging tests including an ultrasound scan. They can be tiny or as big as a grapefruit. It's estimated between 20 and 80 percent of women have fibroids before the age of 50 (they shrink after the menopause), though not all will have symptoms. Fibroids can cause urinary frequency, painful and heavy periods, lower back pain, painful sex, complications during pregnancy and a swollen abdomen. There are various treatment options available including removal of the lining of the womb (called endometrial ablation), drug treatments and surgery to remove the fibroids or a hysterectomy to remove the uterus.iii

2. Pelvic inflammatory disease is an infection of the upper genital tract including the uterus, fallopian tubes and ovaries, usually caused by a sexually transmitted disease. It can cause pain in the pelvic region and lower abdomen, as well as painful sex and urination. It can be treated with antibiotics and diagnosed by a swab test for bacterial infection. Transvaginal ultrasound, where a probe is inserted into the vagina, can also diagnose inflammation caused by PID. Complications of untreated PID include longer-term pelvic pain and infertility due to damage to the fallopian tubes. Ectopic pregnancy is the medical name for when a fertilised egg travels outside the uterus and implants itself, usually in a fallopian tube. One in 80-90 pregnancies in the UK is ectopic.iv They don't always cause symptoms and are sometimes only picked up as a result of a routine pregnancy scan. As the egg develops it can block the tube causing pain and rupture leading to severe internal bleeding. Ectopic pregnancies are regarded as a medical emergency. Other causes of abdominal pain in women Possible causes of upper abdominal and pelvic pain include:  Gallstones:These are small stones, usually made of cholesterol, a waxy substance made in the liver, that form in the gallbladder. They're more common in women, especially those who've had children, are taking the combined contraceptive pill or are overweight/obese. Gallstones usually only cause symptoms if they move into the bile duct and cause a blockage. This causes severe pain in the centre of the abdomen and just under the ribs on the right-hand side. An attack can last 1-5 hours and is the most common cause of emergency hospital admissions in the UK for people complaining of abdominal pain. About 8 percent of the adult population has gallstones, and 50,000 people a year need surgery to remove their gallbladder. Their presence is usually confirmed by an ultrasound scan.v  Duodenal/stomac ulcers: Also known as stomach ulcers, these form on the lining of the stomach and an area just beyond in the intestine. They affect 10 per cent of the population.vi Symptoms include a burning or gnawing pain in the centre of the abdomen. The main causes include a bacterial infection called helicobacter pylori and the side effects of prescription medicines including non-steroidal anti- inflammatory drugs (NSAIDs). H.pylori infections can be treated with a course of antibiotics and drugs called proton pump inhibitors to stop acid production.  Kidney stones: These small stones form in the kidneys and affect 3-5 percent of women, compared to 10-20 percent of men. If they block part of the urinary system severe abdominal pain can result (also known as renal colic). Small stones can be passed in urine but others may need breaking up with x- rays or ultrasound.vii  Liver conditions: Non Alcoholic Fatty Liver Disease, caused by a build-up of fat in the liver, can cause a dull ache across the lower left-hand side of the rib cage in the later stages. It's diagnosed by a liver function blood test but can also be detected by an ultrasound scan. It's not serious early on but may eventually cause liver damage. It's treated by lifestyle changes including losing weight.viii Other liver problems include various types of hepatitis or inflammation of the liver. This is usually caused by a viral infection or alcohol abuse. i http://www.nhs.uk/Conditions/Ovarian-cyst/Pages/Introduction.aspx ii http://www.verity-pcos.org.uk/guide_to_pcos/what_is_pcos/pcos_symptoms iii http://www.womenshealth.gov/publications/our-publications/fact-sheet/uterine-fibroids.html iv http://www.nhs.uk/conditions/Ectopic-pregnancy/Pages/Introduction.aspx

3. v http://www.nhs.uk/Conditions/Gallstones/Pages/Introduction.aspx vi http://www.nhs.uk/conditions/peptic-ulcer/Pages/Introduction.aspx vii http://www.nhs.uk/Conditions/Kidney-stones/Pages/Introduction.aspx viii http://www.nhs.uk/conditions/fatty-liver-disease/Pages/Introduction.aspx#symptoms