Acute Ovarian Torsion in a 6-year-old Girl: A Diagnostic Pitfall in the Emergency Department

Abstract

It is still a challenge to investigate and manage acute abdominal pain in the emergency department (ED), especially in children, because physical examination is not as easy as in adults. Acute ovarian torsion in children is an uncommon cause of acute abdominal pain and it is difficult to diagnose in a timely fashion in the ED.1 However, since the diagnostic and surgical urgency after initial examination does appear to have an impact on ovarian salvage2, the emergency physician should remain alert to this clinical entity to avoid irreversible ovarian necrosis. Herein, we report a case of acute ovarian torsion in a 6-year-old girl who presented in our ED with acute abdominal pain, which had initially been diagnosed as constipation at another hospital. Constipation is often confused with this condition in the ED and when making this diagnosis, especially in young girls, a careful re-evaluation and judicious utilization of radiological tools are necessary to rule out possible organ- or life-threatening causes.