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Case Report
Left lower abdominal pain in a premenarchal girl: A case of ovarian torsion
1 General Surgical Registrar, Department of Surgery, Northern Hospital, Melbourne, Victoria, Australia
2 Consultant Paediatric Surgeon, Department of Surgery, Northern Hospital, Melbourne, Victoria, Australia
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Chao Cheng
185 Cooper Street, Epping, Melbourne, Victoria 3076,
Australia
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Article ID: 100076Z06CC2020
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Cheng C, Condron S. Left lower abdominal pain in a premenarchal girl: A case of ovarian torsion. Case Rep Int 2020;9:100076Z06CC2020.ABSTRACT
Introduction: Pediatric ovarian torsion is a rare surgical emergency. In premenarchal girls, ovarian torsion can occur with or without an ovarian cyst. Due to its nonspecific presentation, diagnosis can be very challenging.
Case Report: A healthy 9-year-old girl presented to the Emergency Department with a six day history of intermittent left sided abdominal and flank pain, associated with vomiting. She appeared well on triage, and was triaged for nonurgent review. In the Emergency Department, the patient reported that she was seen by family doctor three days prior for the same symptoms and was treated for urinary tract infection with cephalexin. She denied any bowel habit changes or other systemic symptoms. She examined well, with mild tenderness over the left iliac fossa without guarding. A renal tract ultrasound was requested, and it showed a bulky left ovary with no vascular flow, suggesting ovarian torsion. The patient was subsequently taken to operating theatre and underwent laparoscopic detorsion of her left ovary. She was followed up in outpatient clinic with a pelvic ultrasound done at six weeks postoperatively which showed normal vascular flow and follicles in both ovaries.
Conclusion: In conclusion, ovarian torsion in pediatric premenarchal population is a diagnostic challenge. Abdominal ultrasound is an essential diagnostic aid, and laparoscopy with detorsion is an accepted surgical management.
Keywords: Abdominal pain, Adnexal torsion, Ovarian torsion, Pediatric, Premenarche
SUPPORTING INFORMATION
Author Contributions
Chao Cheng - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sarah Condron - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Chao Cheng et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
