Abstract
Background: Acute abdominal pain in an adolescent female may be either nongynecologic or gynecologic in origin. A careful history, physical exam, laboratory analysis, and radiographic studies assist in determining a diagnosis. In the case of a para-ovarian cyst, a high index of suspicion is essential to narrow the differential and establish a diagnosis. Case: In this paper, we present a case where torsion of a right para-ovarian cyst mimicked an acute abdomen in a 15-year-old female. Pelvic and rectal exams were not permitted by the patient or her mother. A detailed history with normal laboratory findings diminished gastrointestinal, gestational, and urologic causes. Computerized tomography and pelvic ultrasound confirmed a right-sided nonovarian pelvic mass. Torsion of a para-ovarian cyst was suspected prior to surgical exploration. Conclusions: This case highlights the importance of a high index of suspicion for the proper diagnosis and treatment of a para-ovarian cyst torsion. The decision for timely surgery in a healthy, active adolescent female with radiologic confirmation of an adnexal mass presenting with acute abdominal symptoms is paramount for a positive outcome. (J GYNECOL SURG 23:63)
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