Clinical Characteristic of Ovarian Torsion in Children

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  • Okata Yuichi
    Department of Pediatric Surgery, Himeji Red Cross Hospital:Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine
  • Hatakeyama Tadashi
    Department of Pediatric Surgery, Himeji Red Cross Hospital
  • Yasufuku Masao
    Division of Pediatric Surgery, Kakogawa Municipal Hospital

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  • 小児卵巣茎捻転症例の臨床的検討
  • ショウニ ランソウ ケイ ネンテン ショウレイ ノ リンショウテキ ケントウ

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Abstract

Purpose: The aim of this study was to evaluate clinical characteristics of ovarian torsion (OT) in children. Methods: Eight OT cases operated on in our hospital between June 2003 and May 2009 were analyzed for clinical characteristics retrospectively. Results: Median age was 11 years. Seven cases presented with abdominal pain. Nausea or vomiting, and fever presented in four cases. Elevated white blood cell count was observed in 5 cases and CRP elevation was observed in 4 cases. Although three cases were preoperatively diagnosed by imaging methods (abdominal ultrasonography 1, MRI 2), all of these cases required oophorectomy because of severe necrosis of ovarian tissue. Median delay between the first symptoms and surgical procedure was 5 days. All surgical specimens of four cases with fever and CRP elevation had necrotic change in histopathology. Conclusions: Preoperative diagnosis of OT was not easy and a long time elapsed between the first symptoms, diagnosis and treatment. Therefore, earlier use of diagnostic laparoscopy should be recommended for patients who are suspected OT. The presence of fever and CRP elevation may be associated with necrotic change of ovarian tissues.

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