Clinical diagnosis and treatment of 6 cases of acute ovarian torsion causing ovarian necrosis in children

Objective To summarize the clinical experience of acute ovarian torsion in girls and to improve clinicians' understanding of the disease. Methods Retrospective analysis of the clinical data of 6 cases of acute ovarian torsion resulting in ovarian necrosis in girls admitted to the Red Flag Hospital, from January 1, 2016 to February 1, 2023. Results The age distribution of the six cases was 7-13 years old, with a median of 11 years old, of which three were children with menarches and three were not. The clinical presentation was mainly left lower abdominal, right lower abdominal and periumbilical pain. 4 cases underwent ultrasound or CT examination after the first visit, 2 cases had left ovarian torsion and 4 cases had right ovarian torsion. Conclusion When girls approaching puberty present with abdominal pain, parents, teachers and their chaperones should be alert to the possibility of common acute abdominal and paediatric gynaecological disorders in children and they need early consultation and ultrasound or CT examination for definitive diagnosis. Early management of paediatric ovarian torsion is very important for the prognosis of the girls, as the rate of removal of the affected ovary is very high if an untimely diagnosis leads to severe local ischaemia and necrosis. Awareness of gynaecological emergencies, early management and training of paediatric surgeons are important to prevent ovarian torsion leading to ovarian necrosis in children and to improve the potential protection of girls' fertility.