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Intermittent Torsion of a Normal Ovary in a Child Associated with Use of a Trampoline

  • Lynne M. Yancey
    Correspondence
    Reprint Address: Lynne M. Yancey, md, Department of Emergency Medicine, University of Colorado School of Medicine, 12401 East 17th Avenue #B215, Aurora, CO 80045
    Affiliations
    Department of Emergency Medicine, University of Colorado School of Medicine, Denver, Colorado
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Published:February 21, 2011DOI:https://doi.org/10.1016/j.jemermed.2010.11.046

      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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