Non-gynecologic causes of unexplained lower abdominal pain in adolescent girls: two clinical cases and review of the literature.

Unexplained lower abdominal pain in adolescent girls is a common complaint that can pose a challenge for even the most experienced physicians. It is also one of the most frequent conditions prompting a referral to a specialist. The differential diagnosis is lengthy, and the cost of an extensive laboratory evaluation is high. In many cases the pain resolves spontaneously and no cause is found. However, this fact should be coupled with an awareness that occasionally a serious underlying medical or psychiatric disorder exists. The purpose of this paper is to offer guidelines to the clinician caring for adolescent girls with unexplained lower abdominal pain and to stress the value of a thorough history and physical. Clues to the diagnosis and suggestions for management of non-gynecologic conditions will be presented.