Torsion of the normal ovary and oviduct in a pre‐pubertal girl

Abstract

We encountered a 10-year-old prepubertal girl with a normal ovary and oviduct torsion. Hemorrhagic infarction of the ovary and oviduct occurred, and these structures were laparoscopically removed. Torsion of the normal ovary and oviduct in a prepubertal girl is discussed.

Torsion of the Gonad in the Pediatric Population: Spectrum of Histologic Findings with Focus on Aspects Specific to Neonates and Infants

“…Particularly, the presence of more than 1 ligament supporting the ovary, along with the supportive effect of the fallopian tube that acts as a structural scaffold, could provide an additional stability to ovaries, compared to the spermatic cord to testes. This anatomic difference could also explain the more frequent GTNI in males [13,14,[18][19][20][21][22][23][24][25][26], which generally occurs spontaneously without the contribution of a mass effect. Moreover, the complete regression of the testicular tissue in GTNI could be also attributed to an autoimmune mechanism secondary to the phenomenon of antigenic exposure [38], leading to complete destruction of the testicular parenchyma as an end point.…”

“…Management of GT also differs between remote neonatal and recent postnatal gonad torsion in the pediatric population. Urgent surgical exploration is highly advised in the instance of a recent postnatal symptomatic GT, given the real likelihood of gonad salvage in this setting, as opposed to the relative lack of benefits of surgery in more chronic neonatal GT [1,6,8,14,17,33,[38][39][40][41][42]. However, contralateral gonadopexy should be performed in both settings due to the high incidence of synchronous or metachronous bilateral gonad torsion [1,4,6,14,35,38,[40][41][42].…”

“…Urgent surgical exploration is highly advised in the instance of a recent postnatal symptomatic GT, given the real likelihood of gonad salvage in this setting, as opposed to the relative lack of benefits of surgery in more chronic neonatal GT [1,6,8,14,17,33,[38][39][40][41][42]. However, contralateral gonadopexy should be performed in both settings due to the high incidence of synchronous or metachronous bilateral gonad torsion [1,4,6,14,35,38,[40][41][42]. In addition, a limited partial orchiectomy/oophorectomy is recommended by many authors in cases of gonadal torsion with associated benign lesions, whenever resection is judged necessary [4,5,9,43].…”

“…Gonadal torsion (GT) occurs predominantly in the 1st year of life and in prepubertal children [1][2][3][4][5] and may occur as early as the antenatal period [1,[6][7][8][9][10][11][12]. In the male population, testicular torsion is due to rotation of the spermatic cord around its axis, resulting in impairment of the blood supply to the testicle and surrounding structures [13,14]. This condition is thought to be secondary to inadequate and defective connective tissue within the scrotum, but the testis itself is initially normal in approximately half of the cases (47%) [15].…”

Ovarian Torsion in Pediatric Patients: A Single-Institution Case Series and Mini-Review of the Literature

“…In children, the torsion of a normal ovary is more frequent than in adults because of the greater length of the ovarian pedicle [28]. An abnormally long fallopian tube, mesosalpinx or mesoovarium causes an excess of mobility of the adnexa, determining a higher risk of torsion in these girls [29,30].…”