Ovarian Torsion: Not Just an Adult Condition

As a pediatric and adolescent gynecologist, I get a lot of questions about young girls’ bodies. One of the conditions that parents and young girls don’t know a lot about but should is called ovarian torsion. And while it’s not common, the symptoms are often very similar to appendicitis. These similarities can sometimes delay timely and accurate diagnosis of the ovarian torsion.

Ovarian torsion is a condition in which the ovary twists off its blood supply and can result in severe and sudden pelvic pain. Symptoms can also include abdominal or pain, nausea, vomiting, or fever.

This condition generally requires surgery to untwist the ovary.  It is possible to see a twisted ovary, fallopian tube, or both at the time of surgery. We do know that the most likely scenario is that the ovary will be functional in the future if surgery is performed to untwist the ovary.

While ovarian torsion is the fifth most common gynecologic emergency, it is still a relatively rare condition in children and adolescents. Regardless, this condition should always be considered in cases of acute onset abdominal pain in a prepubescent female.

Your child’s doctor should conduct a pelvic ultrasound when evaluating young female patients with acute onset of pain in order to identify the ovaries and any masses or cysts in the pelvis. Generally, torsion occurs when there is an ovarian cyst present, but there are also instances where the ovary is twisted and there is no cyst or ovarian pathology seen at the time of surgery.

It is important to note that there are cases where the fallopian tube is twisted without twisting of the ovary. This presents in the same way as a twisted ovary and it is very difficult to differentiate these conditions without performing surgery.

I try to remind parents and their daughters that ovarian torsion is most often a spontaneous event and does not indicate that a child is sick or will be affected by the torsion long term.  Children generally recover very quickly from surgery performed to correct this condition. Laparoscopic surgery is most often performed and patients can generally go home the same day.

In sum, ovarian torsion can be a painful – and sometimes scary – condition for young girls. But being aware of the symptoms and talking to your doctor can help calm both patient and parents.  Here at Texas Children’s, we ensure that girls are treated carefully and compassionately.

About Dr. Jessica C. Francis, Pediatric and Adolescent Gynecologist

I am a fellowship trained Pediatric and Adolescent Gynecologist at Texas Children’s Hospital.

My clinical interests include congenital problems of the reproductive tract, bleeding disorders, pelvic masses, and minimally invasive surgery in adolescents.
Posted in Adolescent Medicine, Obstetrics and Gynecology, Pavilion for Women

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