128 Recurrent ipsilateral ovarian torsion in a premenarchal girl: What to do? A case report

Abstract

Ovarian torsion is the complete or partial rotation of the adnexal supporting organ. This affects females of all ages. In premenarchal girls, the incidence is rare, being 4.9 in 100.000 [ [1] Ashwal E. Krissi H. Hiersch L. Less S. Eitan R. Peled Y. Presentation, diagnosis, and treatment of ovarian torsion in premenarchal girls. J Pediatr Adolesc Gynecol. 2015; 28: 526-529 Abstract Full Text Full Text PDF PubMed Scopus (33) Google Scholar ]. Ovarian torsion can be caused by ovarian cysts. Ovarian cysts are common in children with an incidence of 5% [ [2] Millar D.M. Blake J.M. Stringer D.A. Hara H. Babiak C. Prepubertal ovarian cyst formation: 5 years' experience. Obstet Gynecol. 1993; 81: 434-438 PubMed Google Scholar ]. Ovarian torsion can also occur in girls with normal ovaries. This happens particularly in premenarchal girls due to the elongated utero-ovarian ligaments [ [3] Nur Azurah A.G. Zainol Z.W. Lim A.A. Zainuddin P.S. Sulaiman A.S. Ng B.K. Update on the management of ovarian torsion in children and adolescents. World J Pediatr. 2014; 11: 35-40 Crossref PubMed Scopus (20) Google Scholar ]. Ovarian torsion is frequently misdiagnosed because symptoms are often nonspecific [ [3] Nur Azurah A.G. Zainol Z.W. Lim A.A. Zainuddin P.S. Sulaiman A.S. Ng B.K. Update on the management of ovarian torsion in children and adolescents. World J Pediatr. 2014; 11: 35-40 Crossref PubMed Scopus (20) Google Scholar ]. Hence, early diagnosis and surgery are essential to preserve fertility and prevent morbidity [ 3 Nur Azurah A.G. Zainol Z.W. Lim A.A. Zainuddin P.S. Sulaiman A.S. Ng B.K. Update on the management of ovarian torsion in children and adolescents. World J Pediatr. 2014; 11: 35-40 Crossref PubMed Scopus (20) Google Scholar , 4 Dasgupta R. Renaud E. Goldin A.B. et al. Ovarian torsion in pediatric and adolescent patients: A systematic review. J of Ped Surg. 2018; 53: 1387-1391 Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar , 5 Comeau I.M. Hubner N. Kives S.L. Allen L.M. Rates and technique for oophoropexy in pediatric ovarian torsion: a single-institution case series. J Pediatr Adolesc Gynecol. 2017; 30: 418-421 Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar ].