Abstract
Acute pelvic pain in reproductive-aged persons who are assigned female at birth is associated with an extensive differential diagnosis, with possible causes ranging from the genitourinary or gastrointestinal to the musculoskeletal or neurovascular, in some cases even extending to psychological and dermatologic presentations. This article presents a case study that serves as an exemplar of the differential diagnosis of acute pelvic pain, culminating in diagnosis of the patient with a hemorrhagic ovarian cyst as well as a review of outpatient surveillance guidelines for adnexal masses. Management of this difficult-to-diagnose condition is reviewed, and special populations are considered.