SOC
Surgery on Children

Surgery on Children Journal aims to publish issues related to Pediatric Surgery, Pediatric Neurosurgery, Pediatric Plastic Surgery, Pediatric Cardiovascular Surgery, Pediatric Orthopedic Surgery, Pediatric Vascular Surgery, Pediatric Gynecology and Obstetrics, Pediatric Ear Nose Throat, Ophthalmology, Pediatric Anesthesiology and Reanimation, Pediatric Urology, Pediatric Surgical Intensive Care Clinic, and other clinical surgery fields on children of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Case Report
The importance of perineal examination: a case report
Abstract
All patients, particularly those presenting with abdominal pain, should be evaluated through a comprehensive and holistic approach. It is essential not to overlook perineal examination in adolescent girls during this assessment. In this case report, we present the diagnostic, follow-up, and treatment process of a 17-year-old girl who was admitted to our clinic with abdominal pain, aiming to raise awareness and contribute to clinical planning for timely and appropriate interventions. A 17-year-old girl with recurrent admissions for abdominal pain had previously been hospitalized in two different healthcare centers with a preliminary diagnosis of acute appendicitis. However, in both instances, she was not operated on due to her family’s refusal to consent to surgery. As her complaints persisted, she was admitted to our clinic for comprehensive evaluation and management. Laboratory tests revealed normal levels of WBC, CRP, and procalcitonin. Abdominal ultrasonography showed no evidence of appendicitis; however, a 2 cm pocket of free fluid was observed in the pelvic region, raising suspicion for pelvic inflammatory disease. Perineal examination revealed poor hygiene and a large amount of foul-smelling, white, curd-like vaginal discharge. The patient also reported intermittent urination. Vaginal culture yielded Zygosaccharomyces species. Following itraconazole therapy, the discharge resolved and hygiene was restored. Uroflowmetry demonstrated a reduced urine flow rate and an increased bladder capacity relative to age norms. As the patient could not cooperate during urodynamic testing, bladder-sphincter dyssynergia was suspected. The patient was instructed on double voiding and toilet training, and propiverine hydrochloride therapy was initiated. Performing a perineal examination and carefully evaluating menstrual and urinary patterns in patients presenting to healthcare facilities with abdominal pain are of great clinical importance for both physicians and nursing care providers. This approach facilitates the early diagnosis of underlying gynecological or urinary tract pathologies and contributes to the prevention of potential complications through timely and appropriate management.

Keywords : Abdominal pain, perineal examination, vulvovaginitis

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Article available in :
Volume 3, Issue 3, 2026
Page : 94-96
https://doi.org/10.51271/SOC-0078
Article Information
Received : 10 Ara 2025
Accepted : 04 Şub 2026
Published : 29 Tem 2026
Corresponding Author :

Sevgi Ulusoy Tangül: Department of Pediatric Surgery, Faculty of Medicine, Kırklareli University, Kırklareli, Turkiye

[email protected]
Citation : Sayar R, Ulusoy Tangül S, Şenaylı A. The importance of perineal examination in adolescent girls presenting with abdominal pain: a case report. Surg Child. 2026;3(3):94-96. doi:10.51271/SOC-0078

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