Ovarian torsion in a two-year-old

Introduction: Ovarian torsion occurs infrequently; and usually another diagnosis, such as appendicitis or intussusception, is initially suspected. Torsion of ovary and testis occurs with equal frequency, yet oophorectomy exceeds orchidectomy by a factor of two. This disparity is attributed to delay in diagnosis and misapprehension of operative findings.& nbsp;Case report: A two-years-old girl presented with abdominal pain and vomiting. Torsion of the right ovary was diagnosed by ultrasound (Figs. 1- 4). The ovary was untwisted laparoscopically and preserved, despite its grossly abnormal appearance (Fig. 5). Two follow-up ultrasounds were performed; both studies showed normal ovaries bilaterally (Figs. 6 and 7).& nbsp;Discussion: Torsion has these prerequisites:& nbsp;.& nbsp; the mass has bulk and is lopsided.& nbsp;.& nbsp; the mass has no surface adhesions.& nbsp;.& nbsp; the mass has a narrow tether. The ovaries of a two-year-old are tiny and unlikely candidates to twist.& nbsp;Ovarian cysts and tumors may elicit torsion, but these are rare during childhood; their estimated incidence is 5/100,000.& nbsp;Conclusion: These considerations and the appearance of the ovary argued for oophorectomy, especially since malignancy, though rare in pediatrics, occurs most frequently in girls who are 2 years-old or less. Nevertheless, the best practice recommendation is preservation of the ovary; and this decision proved correct.