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Mittelschmerz

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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This is the pain associated with ovulation - for many years it was thought to be post-ovulatory but recently it has been demonstrated as a pre-ovulatory finding. It may cause right iliac fossa pain. Characteristically, the pain occurs at the mid-point of the menstrual cycle and often there is a history of recurrent right abdominal pain.

This physiological condition may present similarly to acute appendicitis and always should be included in the differential of appendicitis if presentation is in a menstruating female. Features that help to discriminate it include:

  • fever rare; however, leukocytosis can occur
  • pain settles quickly

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