A 16-year-old female complains of sudden left-sided lower quadrant abdominal pain. Last menstrual period was 2 weeks ago. On physical examination, the abdomen is non-tender with no masses and no organomegaly
Bowel sounds are normal in 4 quadrants. Pelvic examination is within normal limits. Abdominal CT scan is negative. Pregnancy test is negative. These signs and symptoms are consistent with:
A. Ovarian cancer
B. Hydatidiform mole
C. Endometriosis
D. Follicular cyst
ANS: D
Ovarian cysts are common in the younger population and tend to occur in the latter half of the menstrual cycle. Many spontaneously resolve. Others may need surgical intervention if they become twisted, owing to the risk of gangrene. Right or left lower quadrant pain is usually the presenting complaint. Pelvic examination reveals significant tenderness in the affected adnexal area. Rebound tenderness may be present. Follicular cysts are most common, and the pain typically occurs in the second half of the menstrual cycle. These cysts usually resolve with menses and require no further treatment.
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