Ovarian Torsion in a Prepubertal Girl: Infrequent Yet to be Anticipated

Sravani Chithra .Ch, Geetha .V, Senthil Kumar Azhisoor Chandrasekhar, Kundavi Shankar

Abstract: Adnexal torsion accounts for 3% of all gynaecologic emergencies. Of this pediatric ovarian torsion is relatively rare. It consists of a spectrum of pathologies including ovarian torsion, ovarian torsion with tubal torsion and isolated fallopian tube torsion. It is associated with high morbidity if not treated immediately. Patients with adnexal torsion usually present with acute abdominal pain along with gastrointestinal symptoms such as nausea and vomiting. But due to presence of non - specific clinical features, diagnosis of adnexal torsion is a difficult task which requires high degree of clinical suspicion. We report a case of pediatric ovarian torsion in a thirteen year old, where diagnosis was difficult on initial presentation to the hospital due to various factors, which inevitably led to delayed resolution and increased morbidity. To improve diagnosis and shorten time to treatment, the use of laparoscopy for diagnosis of ovarian torsion if indicated by clinical suspicion and supplemental imaging studies will help in prompt diagnosis and timely management, hence preventing irreversible damage to adnexa. Conservative surgery should be preferred to preserve the future reproductive function.

Keywords: ovary, torsion, pain, laparoscopy, imaging