Pediatric ovarian torsion

Ovarian torsion in the pediatric population is rare, however, delays in diagnosis and treatment can result in long term consequences including ischemia and necrosis of the affected ovary and/or fallopian tube. Clinical presentation is often vague and can be variable, thus a high index of suspicion is required for diagnosis. Pelvic ultrasound with color doppler can aid in diagnosis, however, a normal result does not exclude torsion and thus diagnosis is suspected based on patient history and clinical symptoms. Detorsion with ovarian conservation is the gold standard for both definitive diagnosis and treatment, even when the ovary appears necrotic. Following detorsion, long-term follow up demonstrates high rate of ovarian recovery and function highlighting the importance of ovarian preservation. Early recognition and prompt intervention are essential to optimize outcomes and preserve fertility in pediatric patients with ovarian torsion.