title: A 3-year-old female with abdominal pain, vomiting, and an abdominal mass.
abstract: We present a case of a 3-year-old female with a 10-day history of lower abdominal pain, distention, and vomiting, as well as fatigue, low-grade fever, and subjective weight loss who was found to have utero-ovarian torsion with pathology revealing hemorrhagic and infarcted tissue. While the literature is limited, it suggests that utero-adnexal torsion in children may be more common than previously recognized. A missed, or even delayed, diagnosis of utero-adnexal torsion has the potential to result in irreversible ischemic damage. Utero-adnexal torsion should therefore be included in the differential diagnosis for girls presenting with acute abdominopelvic pain. Pelvic ultrasound to evaluate the uterus and adnexae is an important non-invasive first step in establishing the diagnosis. Computed tomography scan or magnetic resonance imaging can be considered in the case of indeterminate ultrasound. The diagnosis of utero-adnexal torsion must be made early, and surgical intervention must be timely in order to preserve fertility.
authors.forename: Jaimee
authors.initials: J
authors.lastname: Holbrook
authors.forename: Christopher
authors.initials: C
authors.lastname: Schneller
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Lapping-Carr
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Hageman
authors.forename: Andrea
authors.initials: A
authors.lastname: Lo
mesh_terms: D015746:Abdominal Pain; D000290:Adnexa Uteri / Q000000981:diagnostic imaging / Q000473:pathology*; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014102:Torsion Abnormality / Q000175:diagnosis*; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging / Q000473:pathology*; D014839:Vomiting