Abstract
Background:
Ovarian torsion without an adnexal mass is an uncommon finding in an adolescent girl. Ipsilateral recurrent ovarian torsion is even more rare. This article presents a case of a recurrent ovarian torsion that presented atypically.
Case:
A 15-year-old girl presented to the clinic in 2019 for pain that was associated with her menstrual cycle. She described the pain as diffuse and occurring intermittently. On physical examination, she had normal vital signs, and her abdomen was soft, non-tender, and nondistended. Her past medical history consisted only of a prior ovarian torsion in 2017 that was treated with surgical detorsion. Two days after this evaluation in the clinic, she developed acute, constant pelvic pain. She was suspected to have a recurrent ovarian torsion and underwent diagnostic laparoscopy and ultimately right salpingo-oophorectomy.
Results:
This patient's postoperative course was uneventful.
Conclusions:
Intermittent, chronic pain is an abnormal presentation of ovarian torsion, which makes the diagnosis difficult. Establishing the diagnosis can be even-more challenging due to the high prevalence of primary dysmenorrhea in adolescent females. For this reason, the variability of presentation and pain profiles of women with abdominal or pelvic pain should not preclude a broad differential, with ovarian torsion in mind.
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