Nina's Clinic

Maya, 11 years old, walks into the Emergency Room holding her right side. Her mom says the pain started yesterday as a dull ache around her belly button, but now it's moved lower and to the right. Maya threw up once this morning and hasn't eaten anything all day — "even my favorite pasta sounds gross," she says. You notice she's walking slowly and hunched over, guarding her abdomen with both hands. When the stretcher hits a small bump, she winces hard. She has a low fever. Her mom asks: "Could it just be something she ate?" Maybe. But the way this pain migrated — starting as a vague ache near the belly button and then moving to a specific spot in the lower right — is a pattern you've seen before. Combined with the vomiting, low fever, and the careful way she guards her belly, you need to examine her and figure out what's going on. Time may matter here.