Acute abdomen presentation of torsion of fallopian tube and the fimbrial cyst in 15 year old patient

Pain, tenderness and rebound tenderness in right iliac fossa in 15 years old is extremely difficult to diagnoses of Fallopian tube&fimbrial cyst torsion especially the incidence is about 1 in 1500000 women in age between 21 and 40 years. This case emphasize the need to include tubal torsion in the differential diagnosis of acute appendicitis even in patients with an unremarkable gynecologic/obstetric history.