ABSTRACT
A previously healthy 11-year-old girl presents to the emergency department with 2 days of worsening lower abdominal and pelvic pain. She has also been nauseated and anorexic, but has had no frank emesis. The pain has not improved with acetaminophen and oral ibuprofen. There is no dysuria, frequency, or urgency. She has not started to menstruate. The patient gives a history of three similar, but less intense, episodes of pain about 3–4 weeks apart over the last three to four months. They each lasted 2–3 days.
