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Paediatric cystic ovarian torsion masquerading appendicitis
Smriti Kapoor1, Shoaib Saeed2, Dinesh Balasubramaniam2
1General Surgery, Maidstone and Tunbridge Wells NHS Trust, Tunbridge Wells, UK smritikapoor@doctors.org.uk.
BMJ Case Reports
|February 18, 2021
Summary
Pediatric ovarian torsion, often caused by hemorrhagic cysts, can mimic appendicitis. This case highlights an unusual presentation in a 7-year-old girl, emphasizing the need for careful diagnosis.
Area of Science:
- Pediatric Surgery
- Gynecologic Surgery
- Emergency Medicine
Background:
- Appendicitis is a common surgical emergency in children.
- Ovarian torsion is a rare but serious gynecologic emergency in pediatric patients.
- Hemorrhagic ovarian cysts can predispose to torsion.
Observation:
- A 7-year-old girl presented with symptoms mimicking appendicitis, including right iliac fossa pain and fever.
- Intraoperative findings revealed a right ovarian hemorrhagic cyst with 360-degree torsion.
- The ovarian cyst and ovary were successfully detorted.
Findings:
- The patient underwent an open appendectomy, but the primary pathology was ovarian torsion.
- Pediatric ovarian torsion secondary to a hemorrhagic cyst >2 cm is uncommon.
- Successful surgical detorsion of the ovary was achieved.
Implications:
- Ovarian torsion should be considered in the differential diagnosis of pediatric appendicitis-like presentations.
- Early recognition and surgical intervention are crucial to preserve ovarian function.
- This case underscores the importance of comprehensive intraoperative assessment in pediatric abdominal pain.
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