• Ziv Tsafrir, Foad Azem, Joseph Hasson, Efrat Solomon, Benny Almog, Hagith Nagar, Joseph B Lessing, and Ishai Levin.
• Department of Gynecology, Lis Maternity Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel. zivtsafrir@gmail.com
• J Minim Invasive Gynecol. 2012 Jan 1; 19 (1): 29-33.

ObjectiveTo assess risk factors, clinical findings and mode of diagnosis and treatment in premenarchal children with surgically verified ovarian torsion (OT).Study DesignA retrospective case review (Canadian Task Force Classification II-2).SettingTeaching and research hospital, a tertiary center.PatientsPremenarchal children with surgically verified OT.InterventionsPatients underwent either laparoscopy or laparotomy.ResultsTwenty-two cases of OT in 20 premenarchal girls (median age 12 years) were identified. Three cases involved recurrent torsion after detorsion without cystectomy. The main presenting symptoms were sudden pain and vomiting. Six patients underwent Doppler examinations, and all demonstrated an abnormal flow. Seventeen interventions were by laparoscopy. Conservative management, mainly detorsion with additional cyst drainage or cystectomy, was performed in 19 cases (86.4%). Oophoropexy was performed in 3 cases (13.6%). Pathologic examination demonstrated 5 simple cysts and 1 dermoid cyst.ConclusionsOvarian torsion in premenarchal girls usually presents with intermittent abdominal pain and abdominal tenderness. Other signs and symptoms are nonspecific. When performed, Doppler imaging may assist in diagnosing ovarian torsion in children. Detorsion followed by cystectomy may prevent recurrence.Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

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