An Adolescent With Severe Abdominal Pain, An Unexpected Outcome

Question: A 14-year-old girl of African descent, presented with severe abdominal pain at the pediatric department. The pain had started 3 days earlier and initially was intermittent, diffuse, and cramping. At presentation it had become continuous, progressively increasing in intensity, and accompanied by vomiting up to 3 times a day. She reported the tendency to move around constantly in search of a comfortable position. There was no fever, diarrhea, or dysuria and she regularly passed stool. Her medical history was unremarkable and she claimed not to be sexually active.

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