An accurate diagnosis of ovarian torsion is critical because of the possible long-term impact on fertility. Ovarian torsion is challenging to diagnose due to a generic clinical presentation and a wide range of imaging appearances. The pediatric group is even more challenging to serve since young people typically fail to define their symptoms or provide a thorough medical history. Imaging is, therefore, critical in diagnosing ovarian torsion in young people. A fourteen-year-old female went to the emergency room complaining of acute left lower quadrant stomach discomfort. She arrived hemodynamically stable with an acute abdomen. Transabdominal ultrasound revealed a primarily anechoic formation spanning 5x5 cm from the left adnexa, with the intact arterial flow but limited lymph node involvement. Transabdominal ultrasound revealed a primarily anechoic formation up to 5x5 cm in size from the left adnexa, with the maintained arterial flow but restricted venous outflow. The patient had an exploratory laparotomy, which revealed a left ovarian cyst (5.2 cm 5.4 cm 2.2 cm) with the left adnexa twisted 720°. The torsion was repaired with a simple cystectomy. Pathology results indicated that the cystic contents were benign. This juvenile patient's ovarian function was preserved thanks to an accurate diagnosis and prompt surgical surgery.
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