2025 Volume 61 Issue 1 Pages 72-77
An 11-year-old girl visited a clinic presenting with vomiting and lower abdominal pain and was diagnosed as having irritable bowel syndrome. One month later, the symptoms recurred. Abdominal MRI revealed an 11-cm-diameter cystic mass contiguous with the ovary, raising suspicion of ovarian torsion. She was referred to our hospital and underwent an emergency laparotomy. Serous fluid was aspirated from the cyst using a S.A.N.D. balloon. The ovary and cyst, located on the right side, exhibited 720° counterclockwise torsion at the base of the fallopian tube. The ovary appeared dark red, and the location of the fallopian tube was unclear. An enlarged structure contiguous with the ovarian mesosalpinx was identified. The intraoperative diagnosis of torsion due to a paraovarian cyst was made, and detorsion and mucosal resection of the cyst were performed with a biopsy of the right ovary. The left ovary was normal. Postoperative pathology confirmed that the resected tissue was tubal epithelium, with the final diagnosis of adnexal torsion due to hydrosalpinx. The patient is currently being followed up with no recurrence of hydrosalpinx and right ovarian atrophy. Adnexal torsion due to hydrosalpinx in pediatric patients is rare, and we present this case with a literature review.
