2019 Volume 55 Issue 1 Pages 115-119
A 3-year-old girl presented to a local hospital with a one-day history of intermittent abdominal pain. She was diagnosed as having gastroenteritis. However, her symptoms continued; therefore, computed tomography (CT) of the abdomen and pelvis was performed. Fluid collection within the left adnexa and a large left ovarian cyst were demonstrated. She was brought to our hospital 48 hours after she had the abdominal pain. Exploratory laparoscopy demonstrated a large left ovarian cyst with the left adnexa twisted. The torsion was reduced but the ovary appeared necrotic. To improve the edema and congestion in her abdomen, delayed cystectomy and ovarian preservation 14 days after the initial laparoscopic detorsion were planned. We diagnosed her as having mature ovarian teratoma by MRI. Unexpectedly, she had mumps after leaving the hospital. Thus, the second cystectomy operation was performed 28 days after detorsion. Delayed cystectomy resulted in the reduction of the edema and congestion, the preservation of the ovary, and the peeling off of the tumor along its clear boundary with the normal tissue. It is necessary to preserve the ovary in children and fertile women. In this study, we report our experience of effective ovarian preservation by elective cystectomy after detorsion, along with some literature review.
