Answer 3 Ectopic pregnancy. With the triad of pelvic pain, vaginal bleeding, and an adnexal mass, ectopic pregnancy is highest on the list of potential diagnoses. Adenomyosis is likely to cause an enlarged uterus with chronic pelvic pain rather than with acute pelvic pain. Leiomyomata, another cause of chronic pelvic pain, are detectable on bimanual examination, which reveals palpable nodules on the uterine surface. Ovarian torsion would present with acute pelvic pain and an adnexal mass, but not vaginal bleeding. Click here to return to the questions

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