A 9-year-old girl presented to the paediatric emergency department with cramping pain in the lower abdomen that began while jumping on a trampoline. The child had been having sporadic episodes of similar pain for the past 3 months. On examination she was afebrile and reluctant to move. She had tenderness to palpation throughout the suprapubic region. Her urinalysis, complete blood count and metabolic panel were unremarkable. A CT scan showed an 8×13 cm ovarian cyst (fig 1). The patient underwent uncomplicated laparoscopic removal of this large benign ovarian cyst.

• Download figure
• Open in new tab
• Download powerpoint

Figure 1 Coronal reconstruction of a contrast-enhanced abdominal CT scan showing the ovarian cyst superior to the bladder.

Symptomatic ovarian cysts are uncommon in the prepubertal female and can be associated with torsion or malignancy. Except for very large cysts such as this case, most simple cysts can be managed conservatively with a follow-up ultrasound.1