Ovarian cyst rupture: Sudden-onset unilateral pelvic pain, often associated with physical activity or intercourse

Pelvic inflammatory disease (PID): Lower abdominal pain, cervical motion tenderness, and adnexal tenderness, often associated with vaginal discharge and fever.

Ectopic pregnancy: Unilateral pelvic pain, vaginal bleeding, and a positive pregnancy test, especially in women of reproductive age with risk factors such as previous ectopic pregnancy or tubal surgery.

Endometriosis: Chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility, often associated with cyclic symptoms

Acute appendicitis: Periumbilical pain migrating to the right lower quadrant, associated with anorexia, nausea, vomiting, and localized tenderness on examination

Renal colic: Flank pain radiating to the groin, associated with hematuria and urinary symptoms

Gastrointestinal causes: Various gastrointestinal conditions such as diverticulitis, inflammatory bowel disease, or gastroenteritis can present with lower abdominal pain, often associated with altered bowel habits, bloating, or rectal bleeding.

Ovarian Cyst Rupture: Symptomatic management with NSAIDs for pain relief.
-Observation and monitoring for resolution of symptoms, with consideration of pelvic ultrasound if diagnosis is uncertain or if complications are suspected

Pelvic Inflammatory Disease (PID):
Investigations include Pelvic U/S, Pelvic CT Scan, Laproscopy and Vaginal Discharge for the Gram stain and culture
-Empiric antibiotic therapy targeting common pathogens (e.g., ceftriaxone plus doxycycline with or without metronidazole).
-Partner notification and treatment if applicable.
-Follow-up to ensure resolution of symptoms and consideration of pelvic imaging if no improvement or if complications (e.g., tubo-ovarian abscess) are suspected.

Ectopic Pregnancy:
-Urgent referral to a gynecologist for further evaluation and management.
-Assessment of hemodynamic stability and consideration of surgical intervention (e.g., laparoscopy) or medical management with methotrexate depending on the clinical scenario.
-Serial monitoring of beta-human chorionic gonadotropin (beta-hCG) levels and ultrasound to ensure resolution and exclude ongoing ectopic pregnancy.