An Insidious Cause of Abdominal Pain in a Preschooler Girl

Abstract

The ovarian torsion (OT) represents one of the most misleading and challenging diagnoses for the pediatrician. Symptoms are often nonspecific, including sudden, piercing localized lower abdominal pain and tenderness associated with a palpable mass and peritoneal signs. Although the adnexal torsion is most frequently unilateral, cases of bilateral synchronous or asynchronous have been recorded; in the latter, the OT involved both ovaries at different settings. We reported the case of a 6-year-old girl who presented an asynchronous bilateral OT.

Diagnosis and Management of Pediatric Ovarian Torsion in the Emergency Department: Current Insights

“…Asynchronous bilateral torsion is a rare entity in children, having been reported only 30 times in the literature. 52 History of prior torsion is a risk factor for subsequent ipsilateral or contralateral torsion, and some authors suggest that oophoropexy should be considered in all cases of pediatric torsion. 53 The overall rate of recurrent torsion is 0.2% with no difference seen between ovarian preservation surgery and oophorectomy.…”