This female patient presents with lateralized pelvic pain, concerning for torsion. DDX includes TOA, PID, and other infectious symptoms but patient has no constitutional symptoms of infection. Ectopic is on the differential but unlikely. Also includes UTI, pyelo, endometriosis, adenomyosis but these are less likely. Doubt appendicitis or other primary gastrointestinal process.

Plan: labs, upreg, pelvic US, consder CT scan, pain and nausea control, fluid resuscitation, reassess