CASE PRESENTATION
A 16-year-old unmarried female presented to the emergency department
with chief complaints of lower abdominal pain and per-vaginal bleeding
for 1 day. Abdominal pain was acute in onset, continuous, moderate to
severe in intensity, non-radiating without aggravating and relieving
factor. The patient also had per-vaginal bleeding 1 day back, soaking a
full blanket with blood on 1st day of her cycle. She had her menarche at
the age of 13. Her cycles were irregular for 1 and a half years with
polymenorrhagia cycles repeating in 15-20 days with a flow of 5-6 days
with 3 pads soaked per day but no history of dysmenorrhea. There was no
history of nausea, vomiting, fever, trauma to the abdomen, abdominal
distension, fatiguability, or easy bruising.
At the presentation to the hospital, she was ill-looking pale with a
pulse rate of 86 bpm, regularly regular with a blood pressure of 110/60
mmHg. Her respiratory rate was 22 bpm with SpO2 of 96% and temperature
of 97.2°F (36.2°C). She had a Glasgow Coma Scale of 15/15 (i.e.,
E4M5V6). All systemic examinations were normal. The per-vaginal
examination was not performed for the unmarried lady.