In a literature review of pediatric OT, most patients presented with peripheral leukocytosis, lower quadrant abdominal pain without radiation, and vomiting.7 Another study found that vomiting, short duration of abdominal pain (less than six hours), and a high C-reactive protein level have a high predictive value when diagnosing OT.8 Clinical presentation of OT in the premenarchal population has been found to be different than the postmenarchal population. The gene discussed is CRP; the disease is Increased total leukocyte count.