Case presentation A 15-year-old teenager presents to ED with several days of left-sided abdominal pain, mild vaginal bleeding, and dizziness. Upon further questioning, you learn that she has had near-syncopal episodes the last few times she has tried to stand up. She denies fever, sexual activity, previous episodes of mid-cycle vaginal bleeding, and abdominal or genitourinary trauma. Examination She looks pale and tachycardic.
She has abdominal pain with rebound and guarding in the upper and lower left quadrants that radiate to the back. Laboratory results Hb: 5 g/dL White count: 12,000/mm 3 Platelet count: 210,000/mm 3 Serum B-HCG: 1800 mIU/mL What is the most likely diagnosis for this teenager? NOTE: No other information about the patient is available. *This Case Challenge is from the Editorial Team of Docplexus and is meant for educational purposes only.
