Subsequent asynchronous torsion of normal adnexa in children

Children who have suffered from ovarian torsion may be at increased risk for a repetitive event. Torsion in a normal adnexa may be due to excessive mobility resulting from congenitally long supportive ligaments. Oophoropexy or shortening of the ligamentous support of the remaining functional ovary after torsion is recommended in attempt to prevent a subsequent torsion. The evaluation of young females with abdominal pain should always include the consideration of ovarian torsion. Preoperative ultrasonography is not invasive and could lead to earlier operative intervention resulting in salvage of ovarian tissue. Observation in these same children may allow a torsed edematous ovary to convert to a nonviable necrotic tissue necessitating oophorectomy. Laparoscopy is useful in cases in which the diagnosis is unclear.