A 5 Year Old Girl with Incidental Finding of Ovarian Tissue at the Time of Inguinal Hernia Repair

Abstract

entrapment. Three days post-operatively, the patient had fever and a drop in hemoglobin. Imaging showed hemoperitoneum with no active site of bleeding. She was managed conservatively with IV fluids. At three weeks post-operation, the patient was doing well. She restarted oral contraceptive pills for ovarian suppression and is considering interval oophoropexy via shortening of the utero-ovarian ligament. Comments: This scenario describes unusual recurrent idiopathic unilateral ovarian torsion occurring in a young girl. There are multiple theories regarding recurrent ovarian torsion in this population, and etiology remains unclear. It is agreed upon, however, that the potential causes of ovarian torsion are different between pre-menarchal and post-menarchal patients. In this patient's case, it is interesting that she had occurrences both pre-and post-menarche. Adnexal torsion in pre-menopausal women is an emergency requiring prompt surgical evaluation. Recurrent adnexal torsion without known cause is a suggested indication for oophoropexy. Torsion years after a procedure has rarely been represented in the literature. In addition, an adhesion was found in the posterior pelvis, creating a space that we believed problematic for potential bowel entrapment. This complication of oophoropexy is not described in the existing literature yet, and should be a consideration when managing recurrent ovarian torsion in a young patient.