Author: Brett Martindale, MD
Co Author #1: Brent S.E. Rich, MD
Editor: Shayne Fehr, MD
Three female collegiate volleyball players each complain of left-sided abdominal pain of sudden onset following a volleyball point. Each is a right-hand dominant outside hitter. Each injury occurred during practice, early in the volleyball season. Each athlete presented approximately 1-2 weeks apart from each other, and about 3-5 days after the injury occurred. They complain of left-sided anterior abdominal pain, worsened by continued volleyball play, particularly spike shots. they complain of a feeling of fullness or swelling isolated to the left abdomen, which is tender to touch. Each patient has rested, iced the affected area, and done light abdominal rehabilitation exercises overseen by their athletic trainer.
Review of systems is positive for abdominal pain with lumbar extension and abdominal flexion. It is negative for any gastrointestinal, genitourinary, or systemic symptoms or fever.
None of the athletes has significant past medical, family, surgical, or social history. None of the athletes take prescribed or over-the-counter medications regularly.
Each player presents with similar physical examination findings:
General: Well-appearing, physically fit young adult female athletes. Vital signs are within normal limits.
GI: Abdomen are soft and non-distended. There is focal tenderness to palpation just left and inferior to the umbilicus. Carnett sign is positive.
Skin: One athlete has a small amount of bruising over the area of tenderness. Two of the athletes have some fullness or swelling focally around the area of concern.
MSK: Active abdominal flexion is painful
Remaining systems are unremarkable.
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