[Gynecologic origin of acute abdomen in childhood]

In cases of acute abdominal pain in girls a gynecological cause must always be considered. Neoplasms and cystic adnexal lesions complicated by hemorrhage, torsion, and infarction can be diagnosed in childhood. Ovarian tumors without endocrine activity are frequently very large at the time of discovery. Intravaginal foreign bodies, inflammation, and congenital obstructive malformations are seldom found in patients with acute abdominal pain. Ultrasound has become the diagnostic method of choice. When used by an experienced examiner, its results are nearly as good as MRI. In evaluation with clinical data and serological results, an exact diagnosis can be made by ultrasound, even if the sonomorphological pattern seems confusing. Solid adnexal mass and complex malformations require MRI as a complementary diagnostic step. X-ray studies and computed tomography are less important diagnostic tools in girls with acute abdominal pain caused by gynecological disease.