Abstract
Background
Ovarian torsion is rare in children. It usually occurs in the presence of ovarian
or pelvic pathology. The course of symptoms is typically hours to days. Some authors
have speculated that sudden acceleration/deceleration movements may precipitate torsion.
Objectives
The objective of this report is to describe a case of intermittent abdominal pain
lasting nearly 6 months, which started when the child began playing regularly on a
trampoline, and was ultimately diagnosed as intermittent ovarian torsion of an otherwise
normal ovary.
Case Report
A 12-year-old girl presented to the Emergency Department (ED) with 2 h of abdominal
pain and vomiting. She reported similar episodes over the previous 6 months. Initial
ultrasound, obtained between episodes, was normal. Repeat ultrasound at ED presentation
showed no blood flow to the left adnexa. Surgery confirmed the ovary to be twisted
1080 degrees and markedly edematous due to vascular engorgement. The family retrospectively
identified the onset of the first episode as happening the same week the child had
begun playing regularly on a trampoline. After surgery, she no longer played on the
trampoline. At follow-up 22 months later, she had had no recurrence of her symptoms.
Conclusion
Intermittent ovarian torsion should be considered as a rare cause of recurrent abdominal pain
in children. The presence of blood flow with Doppler ultrasound during acute symptoms
does not exclude the diagnosis. Clinicians might also ask about unusual physical activities
because several authors have theorized that ovarian torsion could be precipitated
by sudden acceleration/deceleration movements.
Keywords
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Article info
Publication history
Published online: February 21, 2011
Accepted:
November 1,
2010
Received in revised form:
April 15,
2010
Received:
January 13,
2010
Identification
Copyright
© 2012 Published by Elsevier Inc.
