Ovarian torsion in an adolescent: A case report and review of diagnostic challenges.

INTRODUCTION AND IMPORTANCE

Ovarian torsion is an uncommon but serious cause of acute abdominal pain in children. Due to its nonspecific symptoms and diagnostic difficulties, timely identification and intervention are crucial to preserving ovarian function and future fertility.

CASE PRESENTATION

A 13-year-old woman presented a 3-day history of pain and vomiting from the right iliac fossa. Clinical examination revealed localized tenderness without abdominal contracture or palpable masses. Laboratory results were unremarkable, and imaging showed a simple 5 cm unilocular ovarian cyst with hyperechoic content and an enlarged right ovary. Laparotomy confirmed a right ovarian torsion with a necrotic ovary. Despite detorsion, no reperfusion was observed, necessitating a right adnexectomy. The postoperative course was straightforward.

CLINICAL DISCUSSION

Ovarian torsion is rare but poses a significant diagnostic challenge due to its variable clinical and radiological presentation. The primary diagnostic tool is ultrasound, often supplemented by Doppler imaging, although the absence of a Doppler signal does not rule out torsion. Differential diagnoses include appendicitis, hemorrhagic cysts, and other conditions that mimic acute abdomen.

CONCLUSIONS

Early recognition and management are essential, particularly in young patients, to mitigate long-term reproductive consequences.