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Ovarian torsion: clinical and imaging presentation in children

J S Meyer1, C M Harmon, M P Harty

  • 1Department of Radiology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.

Journal of Pediatric Surgery
|October 1, 1995
PubMed

Insights

Ovarian torsion in children is rare with vague symptoms. Prompt imaging and surgical intervention are crucial for improving the chances of saving the affected ovary.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Gynecology

Background:

  • Ovarian torsion is an uncommon gynecologic emergency in children.
  • Clinical presentation is often nonspecific, leading to diagnostic challenges.

Purpose of the Study:

  • To evaluate the impact of imaging on the clinical management of pediatric ovarian torsion.
  • To identify factors influencing ovarian salvage rates in pediatric patients.

Main Methods:

  • Retrospective review of 12 children (13 episodes) with ovarian torsion.
  • Analysis of clinical presentation, imaging findings (primarily ultrasound), and surgical outcomes.
  • Categorization of patients by age group: neonates, premenarchal, and postmenarchal.

Main Results:

  • Ultrasound identified complex cysts in neonates and suggestive solid masses in older children, necessitating surgery.
  • Ovarian salvage was achieved in only 1 of 3 same-day surgeries, with another patient having partial ovarian preservation.
  • Delays in presentation and diagnosis contributed to low ovarian salvage rates.

Conclusions:

  • A high index of clinical suspicion for ovarian torsion is essential in pediatric patients.
  • Expeditious diagnostic imaging and familiarity with varied presentations can reduce surgical delays.
  • Improved diagnostic timeliness is critical for enhancing ovarian salvage likelihood in pediatric ovarian torsion.

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