Published: 2020-05-27

Paediatric ovarian torsion: a case report and review of literature

Umang ., Harleen Kaur Cheema, Sidharth Khullar, Madhu Nagpal


Ovarian torsion is a surgical emergency, can result in ovarian loss, intra-abdominal infection and even death. Paediatric ovarian torsion is a rare condition, requires high clinical suspicion and prompt diagnosis. Diagnosis is a challenge since signs and symptoms are similar to those of other causes of acute abdominal pain such as appendicitis, gastroenteritis, urinary tract infection, renal colic or other conditions of acute abdominal and pelvic pain. Here, authors describe a case of a 4-year-old girl with a presentation of acute abdominal pain, treated empirically elsewhere. After investigations, a provisional diagnosis of ovarian torsion was made and patient was taken up for surgery. Intraoperatively, ovary was found to be necrosed. Detorsion was tried but ovary was unsalvageable. Right sided salpingectomy with oophorectomy was performed. Conservative surgery by laparoscopic detorsion can be tried in cases of ischemia but if necrosis has already set in, then salpingo-oophorectomy has to be performed.


Acute abdominal pain, Paediatric ovarian torsion, Salpingo-oophorectomy

Full Text:



Breech LL, Hillard PJA. Adnexal torsion in pediatric and adolescent girls. Current Opin Obstet Gynecol. 2005;17:483-9.

Aziz D, Davis V, Allen L, Langer JC. Ovarian torsion in children: is oophorectomy necessary? J Pediatr Surg. 2004;39:750-3.

Bridgette DG, Mark DA, Elizabeth CP. Incidence and trends of paediatric ovarian torsion hospitalisations in the United States, 2000-2006. Paediatr. 2010;125:532.

Hannah CC, Shweta B, Vikram SD. Pearls and pitfalls in diagnosis of ovarian Torsion. Radio Graph. 2008;28:1355-68.

Nicolas DH, Julina DJ. Torsion of the adnexa. Clin Obstet Gynecol. 1985;28:375-80.

Hibbard LT. Adnexal torsion. Am J Obstet Gynecol. 1985;152:456-61.

Hoey BA, Stawicki SP, Hoff WS, Veeramasuneni RK, Kovich H, Grossman MD. Ovarian torsion associated with appendicitis in a 5-year-old girl: a case report and review of the literature. J Pediatr Surg. 2005;40(9):e17-20.

Pomeranz AJ, Sabnis S. Misdiagnoses of ovarian masses in children and adolescents. Paediatr Emerg Care. 2004;20:172-4.

Albayram F, Hamper UM. Ovarian and adnexal torsion: spectrum of sonographic findings with pathologic correlation. J Ultrasound Med. 2001;20:1083-9.

Mishra V, Hokabaj S, Roy P, Aggarwal R, Vyas B, Mehta N. Case series of paediatric adnexal torsion: rare yet urgent entity. Int J Reprod Contracept Obstet Gynecol. 2017;6:315-9.

Claudio S, Irene B, Valentina P, Josephine L, Elisabetta A, Luca N. Adnexal torsion in children and adolescents: new trends to conservative surgical approach: our experience and review of literature. Gynecol Endocrinol. 2013;29:1.

Poonai N, Poonai C, Lim R, Lynch T. Paediatric ovarian torsion: case series and review of literature. Canadian J Surg. 2013;56(2):103-8.

Mage G, Canis M, Manhes H, Pouly JL, Bruhat MA. Laparoscopic management of adnexal torsion. A review of 35 cases. J Reprod Med. 1989;34(8):520-4.

Vancaillie T, Schmidt EH. Recovery of ovarian function after laparoscopic treatment of acute adnexal torsion. A case report. J Reprod Med. 1987;32(7):561-2.

Galinier P, Carfagna L, Delsol M, Ballouhey Q, Lemasson F, LeMandat A, et al. Ovarian torsion Management. Paediatr Surg. 2009;44(9):1759-65.

Cohen SB, Oelsner G, Seidman DS, Admon D, Mashiach S, Goldenberg M. Laparoscopic detorsion allows sparing of the twisted ischaemic adnexa. J Am Assoc Gynecol Laparosc. 1999;6(2):139-43.

Shauna D, Esther O, Sussana IL. Ovarian torsion: diagnostic features on CT and MRI with pathologic correlation. Am J Roentgenol. 2012;198(2):122-31.

Oltmann SC, Fischer A, Barber R, Huang R, Hicks B, Garcia N. Cannot exclude torsion- a 15-year review. J Pediatr Surg. 2009;44(6):1212-6.