Adnexal torsion in middle chilhood, a rare cause of abdominal pain

Abstract

Adnexal torsion is a rare cause of abdominal pain in middle childhood and, in general, the diagnosis is often delayed due to the lack of specificity of symptoms and imaging tests. We describe the case of a girl in middle childhood who came to the emergency department for pain in the right iliac fossa of approximately 15 hours of evolution associated with partial refusal of food intake and vomiting. The initial examination showed normal vital signs, a soft abdomen, pain on palpation in the lower region, but no signs of peritoneal irritation, a mild leucocytosis with no other signs of infection and the initial abdominal ultrasound showed no objective pathology. Finally, after clinical worsening and a repeat imaging test, she was diagnosed with right ovarian torsion.