Pediatric Torsion of the Ovary and Fallopian Tube

Pediatric Torsion of the Ovary and Fallopian Tube

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Summary

Torsion of the ovary and fallopian tube occurs when they become twisted on their ligament supports – cutting off blood supply to the ovary and/or fallopian tube. It is one of the most common gynecologic emergencies, and it can affect girls and women of all ages. Most cases affect women under the age of 30.

Causes

Torsion may be caused by:

  • Abnormalities of the ovary or fallopian tube, such as an elongated utero-ovarian ligament
  • Large ovarian or tubal cysts or other benign masses
  • Trauma to the ovaries or fallopian tube

Symptoms

If your daughter is experiencing torsion of the ovary and fallopian tube, her symptoms may include:

  • Diarrhea
  • Dizziness
  • Fever
  • Lower abdominal tenderness
  • Lower abdominal swelling
  • Lower back pain
  • Nausea and/or vomiting
  • Sudden, severe lower abdominal pain on one side

These symptoms are very non-specific and could be indicators of a variety of other conditions including gastroenteritis (stomach flu),appendicitis, ruptured ovarian cyst, pelvic inflammatory disease, bowel obstruction, ectopic pregnancy, and more. It’s important to seek immediate medical care for severe symptoms.

Tests and Diagnosis

Torsion of the ovary and fallopian tube is often diagnosed in the emergency room because of the sudden onset of severe pain. Whether you’ve brought your daughter to the ER or her regular doctor, the doctor will begin by conducting a physical exam and asking about all of her symptoms.

Additional testing to confirm the diagnosis may include:

  • Pelvic ultrasound
  • CT scan or MRI of the abdomen and pelvis
  • Blood test
  • Pregnancy test
  • Laparoscopy – during which a thin tube with a camera on the end is inserted through a small abdominal incision to view the ovaries and fallopian tubes

Treatments

If your daughter is diagnosed with torsion of the ovary and/or fallopian tube, she will be treated with surgery to untwist the structures. In the most severe cases, an ovary and/or fallopian tube damaged by lack of blood supply may have to be removed.

In addition to surgery, your daughter may be given prescription or over-the-counter pain medications, intravenous fluids, and medications to stop nausea and vomiting.

Resources

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