Acute ovarian torsion in children

BACKGROUND: Acute ovarian torsion (OT) is an uncommon cause of abdominal pa in in children and is frequently confused with other conditions. METHODS: We reviewed the records (1983 to 1999) of all children treated for acute OT at our children's hospital. RESULTS: Mean child age (n = 51) was 12.5 +/- 0.3 years. Children presented with either right-sided (n = 29) or left-sided (n = 22) pain. Diagnosis of OT was confirmed preoperatively by ultrasound (73%) or computed tomography (CT) scan (10%) while nine children (17%) with right-sided pain underwent surgery for presumed appendicitis. Despite a relatively short time from dia gnosis to surgery, ail 51 children required salpingooophorectomy. Contralat eral biopsy was performed in 29% and 57% had an appendectomy. Younger child ren more commonly had either a mature cystic teratoma or torsion with no un derlying abnormality as an etiology compared with OT in older children that was more likely to result from either a follicular or corpus luteal cyst. Pathologic examination of the contralateral ovary and appendix was normal i n all children who underwent biopsy and appendectomy. CONCLUSIONS: Ultrasonography with color doppler is helpful for differentiat ing acute OT from appendicitis. Although the twisted ovary can rarely be sa lvaged, the etiology is usually benign. Preoperative serum markers and cont ralateral ovary biopsy may be unnecessary. (C) 2001 by Excerpta Medica, Inc .