A case of laparoscopic detorsion and conservative therapy for adnexal torsion caused by massive ovarian edema

Abstract

  Massive ovarian edema (MOE) is a rare non-neoplastic condition, which was first described in 1969 as a tumor-like enlargement of the ovary, with interstitial edema. The edema is caused by partial intermittent torsion of the ovarian pedicle that interferes with the venous and lymphatic drainage of the ovary. MOE is common in young women, and it presents with acute abdominal pain. Adnexectomy is usually the treatment of choice for MOE. When choosing the method of treatment, techniques that preserve the fertility of the patients should be considered. We report a case of a 12-year-old girl who presented with MOE and acute pedicle torsion. Laparoscopy was performed and the patient was conservatively treated. Although magnetic resonance imaging performed 6 months after the surgery revealed that the ovary was atrophic, the patient experienced no thromboembolic complications, infection, or recurrence of adnexal torsion. This case demonstrates that conservative surgery could be considered to treat adnexal torsion caused by MOE.