The authors report on an atypical clinical picture of an acute abdomen syndrome caused by the rupture of an atypically located pyosalpinx in a 9-year old girl.A perforated right-sided pyosalpinx was found at two locations, firmly adhering to a vesicouterine excavation. Right-sided salpingectomy, appendectomy, pelvic cavity lavage and drainage of the Douglas cavity were performed. The pathohistology indicated a perforated pyosalpinx and catarrhal appendicitis. On bacteriological analysis, Escherichia coli was isolated from the vaginal discharge and from the pus collected from the small pelvis.
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