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An 11-year-old girl presumed to be premenarchal presented to the emergency department with a 24-hour history of constant periumbilical pain that radiated to both flanks. She also noted nausea, urinary frequency, and dysuria, which had preceded the onset of the abdominal discomfort by two days. The patient stated that she had never been sexually active and reported no vaginal discharge, difficulty with bowel movements, or fever, chills, or sweats. Her medical history was unremarkable, and she took no medications. Examination of the abdomen revealed tenderness of the left lower quadrant and suprapubic region on palpation, with rebound and voluntary guarding. . . . [Full Text of this Article] |
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