Differential diagnosis includes various abdominal conditions including ectopic pregnancy, acute appendicitis, urinary tract disease, Crohn’s disease, colonic spasm, ovarian cysts, ovulation pain and endometriosis.

Diagnosis will depend on an assessment of the history, clinical findings and investigations which may include abdominal ultrasound, microurine and tests for N gonorrhoeae and ะก trachomatis. Serum HCG should be done if ectopic pregnancy is included in the differential diagnosis.
Laparoscopy may be necessary particularly if there is no improvement following treatment.
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