Scientific paperAcute ovarian torsion in children
Section snippets
Methods
We reviewed the records of all children (aged ≤16 years) who underwent operative treatment for acute ovarian torsion at Cardinal Glennon Children’s Hospital, Saint Louis University Health Sciences Center between January 1983 and January 1999. Neonates with ovarian masses and torsion were excluded. Hospital charts (including operative and pathology reports) and follow-up records were reviewed. A fever was defined as a temperature greater than 38.5°C. Patients were generally considered for
Results
Mean child age (n = 51) was 12.5 ± 0.3 (8 to 16) years (Figure 1). Children presented with an abrupt onset of either right-sided (n = 29; 57%) or left-sided (n = 22; 43%) pain. Other common signs and symptoms were vomiting (n = 37; 73%), fever (n = 11; 22%), a palpable abdominal mass (n = 10; 20%), and dysuria (n = 7; 14%). The neutrophil (white blood cell) count was elevated 82% of the time. The mean WBC count was 13,000 ± 500 cells/mm3 with a mean of 76% segmented and 7% banded neutrophils.
Comments
Acute ovarian torsion in children is uncommon and difficult to diagnose in a timely fashion. Several studies support our observation that the only constant symptom is pain, which results from occlusion of the vascular supply to the twisted ovary.1, 2 Other reported symptoms may include nausea and vomiting, fever, and urinary symptoms.1 Torsion of the right ovary is more common than the left with a ratio that approximates 3:2. A right-sided dominance has been explained by the sigmoid colon
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