Abstract Background: Ovarian torsion (OT) is a rare but significant gynaecological emergency that requires prompt diagnosis and intervention to preserve ovarian function. It results from the twisting of the ovary and fallopian tube around the vascular pedicle, leading to ischemia and potential necrosis. In pediatric patients, OT is particularly challenging to diagnose due to its nonspecific clinical presentation, often mimicking other causes of acute abdominal pain. Case Presentation: We present a case of OT in an 8-year-old girl, emphasizing the diagnostic challenges, surgical management, and clinical outcomes. The baby was admitted with severe left sided lower abdominal pain and multiple episodes of vomiting. Notably, her pain was initially misdiagnosed as pain due to renal stones (nephrolithiasis) and was managed with analgesics for 3-4 days before the correct diagnosis was made. Imaging studies confirmed OT, showing an enlarged left ovary with a haemorrhagic cyst and absence of vascularity on Doppler ultrasound. An emergency laparoscopy revealed a left ovarian torsion with three twists, engorgement, haemorrhagic changes, and necrosis, necessitating a left salpingo-oophorectomy. Postoperative recovery was uneventful, and the patient was discharged in stable condition with follow-up advice. Conclusion: This case underscores the importance of early diagnosis and prompt intervention in pediatric OT. High clinical suspicion, combined with timely imaging and surgical exploration, is crucial for optimal outcomes. While ovarian preservation is ideal, cases with irreversible necrosis necessitate oophorectomy. Future research should focus on improving diagnostic accuracy and conservative management approaches in young patients. The baby was reviewed after one month, and no issues were reported.
Senthilkumar et al. (Wed,) studied this question.