<s>[INST] My thirteen year old daughter is experiencing acute sharp abdomen pains at LLQ that is radiating to umbilical area.  She also has been vomiting.  She underwent a CT of abd/pelvis and all was normal except small amount of fluid in the cul-de-sac.  Could this be residual fluid from a ruptured ovarian cyst?  Should we be concerned? [/INST] Hi. Thanks for your query. Yes, small fluid in the Cul-de-sac has to be bothered about as the age of your daughter is just 13, and we do not get fluids in the abdomen unless there is a problem. It may be a fluid from the ruptured follicle as you are right suspecting, if the dates are coinciding with possible ovulation period, which is normally 14 days prior to the next expected period. If she gets asymptomatic within a few days nothing to worry; you can follow up the fluid with simple ultrasonography. If the condition does not resolve, she will need further studies including the tests of blood, urine and stool and if required Diagnostic Laparoscopy for seeing the interior of the stomach, and to get the fluid for analysis to find the probable cause. The other causes in a child of 13 years can be appendicitis, tuberculosis, primary peritonitis. And so on. </s>