Pediatric Acute Abdomen: Coexistence of Mature Ovarian Teratoma and Reactive Appendicitis. A Case Report

Introduction: Acute abdominal pain in childhood represents a frequent diagnostic challenge in pediatrics. Acute appendicitis is the most common surgical cause; however, in premenarchal girls, gynecological pathologies such as ovarian teratomas—benign germ cell tumors that may remain asymptomatic or present with symptoms once complications arise—should also be included in the differential diagnosis. Materials and Methods: We report the case of an 11-year-old patient presenting with acute abdominal pain. Clinical evaluation was complemented by imaging studies; ultrasound, non-contrast and contrast-enhanced computed tomography, that revealed a mature cystic ovarian teratoma associated with a reactive appendiceal inflammatory process. Results: The patient underwent surgical intervention consisting of teratoma resection and appendectomy. Postoperative recovery was succesful, with no complications. Discussion and Conclusions: This case highlights the relevance of a multidisciplinary approach in the evaluation of acute abdomen, where imaging plays a pivotal role in achieving diagnostic accuracy. The coexistence of gynecological pathology with reactive appendiceal involvement underscores the need to consider non-gastrointestinal causes. Incorporating gynecological assessment into pediatric diagnostic protocols is essential to ensure comprehensive care, safeguard reproductive health, and improve long-term outcomes.