31st July 2023

A 23-year-old woman presents to the A&E department with severe right-sided abdominal pain. She describes it as “sharp” and “coming and going”

A 23-year-old woman presents to the A&E department with severe right-sided abdominal pain. She describes it as “sharp” and “coming and going”. She feels nauseous and has vomited several times. Her urinary pregnancy test is negative, and bloods are unremarkable. On examination, she is tender in the RLQ of her abdomen.

A transvaginal ultrasound scan is done, which shows a ‘whirlpool’ sign.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.