Skip to main content
SpringerLink
Log in

Case of the Girl with Abdominal Pain

  • Chapter
Adolescent Gynecology

  • 922 Accesses

Abstract

Case: A 14-year-old postmenarcheal female presented to the emergency room with an 8-day history of right lower quadrant abdominal pain and associated nausea, vomiting, sweating and headache. Ultrasound demonstrated a complex cyst with normal vascular Doppler flow.Discussion: Functional cysts typically present with chronic aching abdominal pain. They may be associated with adnexal torsion, which should be ruled out immediately in any female presenting with lower abdominal pain. On ultrasound, functional cysts appear as simple, anechoic, thin-walled masses. However, they may also appear complex if they are hemorrhagic in nature. Functional cysts resolve spontaneously and therefore should be managed expectantly with follow-up ultrasound 2 to 3 months following initial presentation. Combined hormonal contraceptives can be used to prevent recurrence of functional cysts. If the cyst persists and is greater than 4 cm, diagnostic laparoscopy should be performed to rule out other adnexal pathologies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Bibliography

  1. Kirkham YA, Kives S. Ovarian cysts in adolescents: medical and surgical management. Adolesc Med. 2012a;23:178–91.

    Google Scholar 

  2. Kives S, Gascon S, Dubuc E, Van Eyk N et al. No. 341-Diagnosis and management of adnexal torsion in children, adolescents and adults. J Obstet Gynaecol Can. 2017;39(2):82–90.

    Article  Google Scholar 

  3. Kokoska ER, Keller MS, Weber TR. Acute ovarian torsion in children. Am J Surg. 2001;180(6):462–5.

    Article  Google Scholar 

  4. Graif M, Shalev J, Strauss S, Engelberg S, Mashiach S, Itzchak Y. Torsion of the ovary: sonographic features. AJR Am J Roentgenol. 1984;143(6):1331–4.

    Article  CAS  Google Scholar 

  5. White M, Stella J. Ovarian torsion: 10-year perspective. Emerg Med Australas. 2005;17(3):231–7.

    Article  Google Scholar 

  6. Shadinger LL, Andreotti RF, Kurian RL. Preoperative sonographic and clinical characteristics as predictors of ovarian torsion. J Ultrasound Med. 2008;27:7–13.

    Article  Google Scholar 

  7. Rogers EM, Cubides GC, Lacy J, Gerstle JT, Kives S, Allen L. Preoperative risk stratification of adnexal masses: can we predict the optimal surgical management? J Pediatr Adolesc Gynecol. 2014;27:125–8.

    Article  Google Scholar 

  8. Templeman CL, Fallat ME. Benign ovarian masses. Semin Pediatr Surg. 2005;14(2):93–9.

    Article  Google Scholar 

  9. Kirkham YA, Lacy JA, Kives S, Allen L. Characteristics and management of adnexal masses in a Canadian pediatric and adolescent population. J Obstet Gynaecol Can. 2011;33:935–43.

    Article  Google Scholar 

  10. Okai T. Transvaginal sonographic appearance of hemorrhagic functional ovarian cysts and their spontaneous regression. Int J Gynecol Obstet. 1994;44:47–52.

    Article  CAS  Google Scholar 

  11. Zhang M, Jiang W, Li G, Xu C. Ovarian masses in children and adolescents - an analysis of 521 clinical cases. J Pediatr Adolesc Gynecol. 2014;27(3):e73–7.

    Article  Google Scholar 

  12. Laufer MR. Adnexal masses. In: Emans JE, Laufer MR, editors. Emans, Laufer, & Goldstein’s pediatric and adolescent gynecology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2012. p. 381.

    Google Scholar 

  13. Surratt JT, Siegel MJ. Imaging of pediatric ovarian masses. Radiographics. 2001;11:533–48.

    Article  Google Scholar 

  14. Fisher M, Lara-Torre E. Update on key topics in adolescent gynecology. J Pediatr Adolesc Gynecol. 2013;26:51–7.

    Article  Google Scholar 

Recommended Reading

  • Kirkham YA, Kives S. Ovarian cysts in adolescents: medical and surgical management. Adolesc Med. 2012b;23:178–91.

    Google Scholar 

  • Kives S, Gascon S, Dubuc E, Van Eyk N et al. No. 341-Diagnosis and management of adnexal torsion in children, adolescents and adults. J Obstet Gynaecol Can. 2017;39(2):82–90.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Hanna R. Goldberg M.S. & Jasmine Multani H.B.Sc.

  2. Section of Gynecology, Hospital for Sick Children, Toronto, ON, Canada

    Sari Kives M.D., M.Sc.

Authors
  1. Hanna R. Goldberg M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jasmine Multani H.B.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sari Kives M.D., M.Sc.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hanna R. Goldberg M.S. .

Editor information

Editors and Affiliations

  1. Assistant Professor, Pediatrics, Program Director, Post-doctoral Fellowship in Adolescent Medicine, Division of Adolescent Medicine, Children’s Hospital at Montefiore, The Pediatric Hospital for Albert Einstein College of Medicine, Bronx, NY, USA

    Hina J. Talib M.D.

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Goldberg, H.R., Multani, J., Kives, S. (2018). Case of the Girl with Abdominal Pain. In: Talib, H.J. (eds) Adolescent Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-66978-6_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-66978-6_5

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66977-9

  • Online ISBN: 978-3-319-66978-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation