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PUZZLER Right question resolves teen’s pain dilemma Maya M Kumar, MD

THE CASE
A 16-year-old girl presents to an emergency department accompanied by her boyfriend to report a 24-hour history of right lower quadrant pain. The pain is associated with midline lower back pain and light vaginal bleeding (1 to 2 tampons per day). She has experienced some nausea but no vomiting.
WHAT’S THE DIAGNOSIS?

Credit: SHUTTERSTOCK/ALBINA GLISIC



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