I have a 14 yo girls with right sided upper quadrant abdominal pain for last five days, seems to be worsening and tender to the touch. Isolated to right upper quadrant. Back pain on same side since yesterday and now some radiating pain to the opposite side. Fatigue and waves of nausea. No fever. Abdominal ultrasound negative for gall stones; no mention of kidney stones. No pain with urination; variable appetite and nausea does not seem to always correlate with eating. History or constipation but bowel movements have been regular and normal. Previous suggestion of possible ovarian cyst but pain is in liver, kidney, gall bladder are and not pelvis.