ABDOMINAL PAIN IN AN ADOLESCENT
Keywords:abdominal pain, adolescent, ectopic pregnancy
A 16-year-old adolescent presented to the Emergency Department with abdominal pain in the left lower quadrant with two weeks of duration and history of constipation. She denied onset of sexual activity and her last menses occurred three weeks before. On physical examination, she had a mild abdominal tenderness on the left lower quadrant. The initial blood workup and urine were normal. Abdominal and pelvic ultrasounds revealed a complex cyst on the left adnexal region and ascites. The serum hormone human chorionic gonadotropin was positive (2608 mUI/mL). Transvaginal ultrasound showed a simple adnexal cyst with a cobweb-like area contiguous to it. An intrauterine gestational sac was not seen. Exploratory laparotomy was performed showing an hemoperitoneum and a left ectopic tubal pregnancy. Salpingectomy was performed.
The authors intend to draw attention to a rare cause of abdominal pain in adolescence that should be considered in order to avoid a potentially fatal outcome.
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