A 29-year-old woman was presented with prolonged abdominal pain occurring with her periods. She was taking paracetamol and ibuprofen since last two months before going to bed. She complained that her pain has also occurred in between the periods.The pain is dull and constant across the lower abdomen. Her periods are regular and there is no menorrhagia, intermenstrual bleeding. There is no other significant medical history. She has been married for two years and has deep dyspareunia.
She does not use any contraceptive and she was never pregnant in the past Examination A generalised lower abdominal tenderness mostly in the suprapubic area but no masses are palpable. A speculum examination was unremarkable. On bimanual palpation, a uterus is axial and fixed with cervial excitation. The pouch of Douglas is very tender contianing a mass. The adnexae are both tender but no adnexal masses are…
