title: Update on the management of ovarian torsion in children and adolescents.
abstract: BACKGROUND
  Ovarian torsion is commonly seen in young girls. Unfortunately it is often misdiagnosed because of its non-specific symptoms and lack of diagnostic modalities. This article focuses on the diagnostic challenge and also the changes in the management of ovarian torsion.
  
  
  METHODS
  We reviewed original reports on the management of ovarian torsion in young girls published from 1984 till 2014. A literature search was conducted by electronic scanning of five electronic database: MEDLINE, EMBASE, SCI, SSCI and CINAHL. In addition, relevant papers and review articles were hand-searched. The search was limited to English language and human studies. The search was conducted by combining the textwords "ovarian torsion", "adnexal torsion", "adolescents" and "oophoropexy".
  
  
  RESULTS
  There are no specific symptoms that can be identified as a pathognomonic feature of ovarian torsion. Ultrasound is a useful diagnostic tool, but it is not always reliable in absence of an enlarged ovary. Laparoscopic detorsion is recognized as the mainstay of treatment regardless the condition of the ovaries. Reports have shown favorable ovarian function after detorsion. The role of oopheropexy remains controversial.
  
  
  CONCLUSIONS
  Clinicians should be aware of ovarian torsion in girls presenting with abdominal pain. A timely management in this young population can help preserve their ovaries and fertility.
authors.affiliation: Department of Obstetrics and Gynaecology, UKM Medical Centre, Kuala Lumpur, Malaysia, nurazurahag@gmail.com.
authors.forename: Abdul Ghani
authors.initials: AG
authors.lastname: Nur Azurah
authors.forename: Zakaria Wan
authors.initials: ZW
authors.lastname: Zainol
authors.forename: Ani Amelia
authors.initials: AA
authors.lastname: Zainuddin
authors.forename: Pei Shan
authors.initials: PS
authors.lastname: Lim
authors.forename: Aqmar Suraya
authors.initials: AS
authors.lastname: Sulaiman
authors.forename: Beng Kwang
authors.initials: BK
authors.lastname: Ng
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D010049:Ovarian Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D010052:Ovariectomy; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D014463:Ultrasonography