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A Case of Twisted Ovarian Cyst in a Young Patient and Review of the Literature

Idris S, Daud S, Ahmad Sani N, Tee Mei Li S

Am J Case Rep, 2021 Nov 17;22:e933438.

PMID: 34785630 DOI: 10.12659/AJCR.933438

BACKGROUND Adnexal torsion is a gynecologic emergency that dictates immediate surgical intervention. Twisted ovarian cysts are rare in adolescents, but they can cause significant distress to patients. Idiopathic ovarian torsion is uncommon in adolescents and the incidence is reportedly higher in women aged 20 to 40 years. Most twisted cysts in adolescents are benign. In the past, oophorectomy was commonly performed for a torsed ovary, but currently there is a trend toward ovary preservation. The diagnosis of twisted ovarian cyst is based on pathognomonic symptoms and findings from a focused clinical examination and ultrasound. Because the differential diagnosis includes acute appendicitis and gastroenteritis, referral to a gynecologist may be delayed. CASE REPORT We present the case of a huge, twisted ovarian cyst in a 16-year-old girl who presented with an acute abdomen. The initial diagnosis was acute appendicitis, which delayed her referral to a gynecologist. An emergency laparotomy and left salpingo-oophorectomy were performed. The histopathology of the ovarian cyst was reported as serous cystadenoma. CONCLUSIONS The optimal management of a twisted ovarian cyst in adolescents is the subject of much debate. Here, we review the literature on ovarian torsion in children and adolescents. The patient in the case we present had a twisted ovarian cyst that was managed with salpingo-oophorectomy.

Matched MeSH terms: Torsion Abnormality/surgery

Update on the management of ovarian torsion in children and adolescents

Nur Azurah AG, Zainol ZW, Zainuddin AA, Lim PS, Sulaiman AS, Ng BK

World J Pediatr, 2015 Feb;11(1):35-40.

PMID: 25557598 DOI: 10.1007/s12519-014-0536-3

Ovarian torsion is commonly seen in young girls. Unfortunately it is often misdiagnosed because of its non-specific symptoms and lack of diagnostic modalities. This article focuses on the diagnostic challenge and also the changes in the management of ovarian torsion.

Matched MeSH terms: Torsion Abnormality/surgery

A Challenge in Diagnosis and Management: Uterine Torsion in Childhood

Thever Ramasamy V, Sivapatham L, Grover SR, Shanmugam SS, Ganesalingam M

J Pediatr Adolesc Gynecol, 2021 Feb;34(1):61-64.

PMID: 33010465 DOI: 10.1016/j.jpag.2020.09.003

BACKGROUND: Uterine torsion is a rare event, which mostly reported in females with a gravid uterus and is exceptionally rare in children.

CASE: A 9-year-old girl presented with 3 days of intermittent lower abdominal pain. Ultrasound revealed an ovarian mass, but laparotomy revealed an ischemic enlarged ovary and uterus rotated 180°. No reperfusion occurred after 60 minutes. A subtotal hysterectomy and right salpingoophorectomy were thus performed.

CONCLUSION: Uterine and adnexal torsion presents with symptoms similar to those of adnexal torsion. Delays in diagnosis and referral continue to be an issue, resulting in suboptimal outcomes. Uterine torsion, although exceedingly rare in childhood, appears to occur only in the setting of ovarian masses, which provide the impetus for the rotational force to the elongated cervix of the prepubertal uterus.

Matched MeSH terms: Torsion Abnormality/surgery*

Uterine horn torsion in a pregnant cat

Thilagar S, Yew YC, Dhaliwal GK, Toh I, Tong LL

Vet Rec, 2005 Oct 29;157(18):558-60.

PMID: 16258139

Matched MeSH terms: Torsion Abnormality/surgery

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