ABSTRACT
A 14-year-old, previously healthy, Caucasian girl presents to the emergency room with a 2-day history of right lower quadrant abdominal pain, not associated with other gastrointestinal symptoms or fever. Her menstrual periods started 18 months previously and have been irregular. Her last period ended 10 days ago. She is not sexually active. On exam, the emergency department physician elicits right lower quadrant tenderness to palpation, without peritoneal signs. Prior to consulting you, she requests an ultrasound, which demonstrates a normal appendix, normal left adnexa, and an enlarged echogenic right ovary measuring 5 cm in greatest dimension. Doppler interrogation is suspicious for ovarian torsion. Ultrasound images are shown in Figure 58.1.
