Entangled bilateral adnexal torsion in a premenarchal girl: a laparoscopic approach

Bilateral adnexal torsion is a rare event in children. A high index of suspicion, together with prompt surgical treatment, would help to save the ovaries and preserve its function. We report a case of entangled bilateral adnexal torsion managed successfully via laparoscopy. An 11-year-old premenarchal girl complained of chronic intermittent abdominal pain that worsened over 24 hours. Computed tomography of the abdomen and pelvis showed a bilobed cystic tumour (10 cm × 12 cm × 12 cm and 3 cm × 4 cm) lying in the left abdomen and another cystic tumour (10 cm × 6 cm × 5 cm) in the pelvis. At laparoscopy, entangled bilateral adnexal torsion was seen. After disentanglement and detorsion of both adnexa, bilateral ovarian cystectomy was performed, and both ovaries were preserved. This case illustrates that laparoscopic treatment is possible for large entangled bilateral adnexal torsion in children.