Department of Medical Research and Education, National Yang-Ming University Hospital, Yilan, Taiwan.
Pediatr Neonatol. 2011 Feb;52(1):51-4. doi: 10.1016/j.pedneo.2010.12.002. Epub 2011 Feb 18.
Ovarian torsion is a well-known but poorly recognized disease. Although ovarian torsion is the most common complication of ovarian tumors in children, it is an uncommon cause of abdominal pain in pediatric patients. Ovaries can be only salvaged by prompt diagnosis and timely surgical intervention. Acute ovarian torsion without appropriate treatment may result in loss of ovarian function, tissue necrosis, and death. The objective of this article is to present a case of pediatric ovarian torsion and describe the difficulty of distinguishing it from perforated appendicitis in the emergency department (ED). We report a 5-year-old girl who presented to the ED with nausea, tenderness over the right lower guardant of her abdomen, fever, and anorexia. She was initially diagnosed with appendicitis based on physical examination and abdominal computed tomography scan and was sent to the operating room for surgical exploration. The definite diagnosis of the patient was acute ovarian torsion complicated with cystic teratoma. Primary clinicians in the ED should pay more attention to acute ovarian torsion in young children because it is difficult to diagnose in time to salvage the gynecological function when the clinical presentations masquerade as perforated appendicitis.
卵巢扭转是一种众所周知但识别度低的疾病。尽管卵巢扭转是儿童卵巢肿瘤最常见的并发症，但它也是儿科患者腹痛的一个不常见原因。卵巢只有通过及时诊断和及时手术干预才能得以保留。未经适当治疗的急性卵巢扭转可能导致卵巢功能丧失、组织坏死和死亡。本文的目的是介绍一例儿科卵巢扭转病例，并描述其在急诊科（ED）与穿孔性阑尾炎相鉴别的困难。我们报告了一例 5 岁女孩，因恶心、右下腹部压痛、发热和厌食就诊于 ED。根据体格检查和腹部计算机断层扫描，她最初被诊断为阑尾炎，并被送往手术室进行手术探查。患者的明确诊断为急性卵巢扭转合并囊性畸胎瘤。ED 的初级临床医生应该更加关注幼儿的急性卵巢扭转，因为当临床表现伪装为穿孔性阑尾炎时，很难及时诊断以挽救妇科功能。
