title: Ovarian torsion in a three-year-old girl.
abstract: BACKGROUND
  Ovarian torsion is the fifth most encountered gynecological emergency requiring surgery. Representing only 2.7% of surgical emergencies, it is an entity that is worth being familiar with in the emergency department (ED).
  
  
  OBJECTIVE
  Untreated ovarian torsion may result in loss of ovarian function, tissue necrosis, and death from thromboembolism or sepsis. Presenting with vague symptoms and abdominal pain, diagnosing ovarian torsion can be difficult, especially in children. The objective of this article is to present a case of pediatric ovarian torsion and to review its epidemiology, diagnosis, and treatment.
  
  
  METHODS
  A 3-year-old girl presented to the ED with vomiting, fever, anorexia, and abdominal pain. Initially diagnosed with appendicitis by physical examination and computed tomography scan, this patient was taken to the operating room for surgical exploration. The patient was subsequently found to have ovarian torsion, which was treated appropriately.
  
  
  CONCLUSIONS
  Although a rare phenomenon, this case serves to increase awareness of the clinical presentation of ovarian torsion in the pediatric patient. Abdominal pain in the female child represents a challenging differential diagnosis, for which a physician must consider ovarian torsion.
authors.affiliation: Department of Emergency Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia 23708, USA.
authors.forename: Todd Justin
authors.initials: TJ
authors.lastname: Ochsner
authors.forename: Joel A
authors.initials: JA
authors.lastname: Roos
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Johnson
authors.forename: Janet L
authors.initials: JL
authors.lastname: Henderson
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D001064:Appendicitis / Q000175:diagnosis*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000000981:diagnostic imaging*