WOFAPS 2025 8th World Congress of Pediatric Surgery

Fatma Thamri, Senda Houidi, Asma Guitouni, Hela Oueslati, Yosra Kerkeni, Sondes Sahli, Riadh Jouini, Said Jlidi

Department of Pediatric Surgery, Children’s Hospital, Faculty of medicine of Tunis, Tunis El Manar University, Tunis, Tunisia

Purpose

Historically, assessment of arterial and venous flow has served as a diagnostic modality for identifying ovarian torsion (OT). Yet, recent radiological investigations propose that a discernible size difference between the ovaries could potentially serve as a more effective diagnostic parameter.

The aim this study was to determine whether this radiological finding is valid in the pediatric population.

Methods

A retrospective descriptive and analytic study involving 55 premenarchal patients who underwent surgical intervention for suspected ovarian torsion between January 2022 and December 2024 was performed. Patients were divided into two groups based on intraoperative confirmation of ovarian torsion (group 1, n=31) or not (group 2, n=24).

Sonographic findings were assessed, and the correlation between preoperative ovarian size and ovarian torsion was evaluated.

Results

All patients presented with sudden onset of severe abdominal pain and underwent pelvic ultrasound followed by laparoscopic exploration. Ovarian torsion was predominantly right-sided (62%). Patients in group 1 had significantly larger ovarian size (OS) compared to those in group 2 ([52.27mm ± 16.88mm] vs [39.25mm ± 12.06mm]; p < 0.001). In 10.3% of torsed ovaries with an OS greater than 50 mm, an ovarian mass was found. The presence of peripherally displaced follicles increased the suspicion of ovarian torsion (p=0.005). In group 1, 58% of patients had color flow (venous or arterial) on Doppler ultrasound compared to 9 patients in group 2 (p=0.266). Additionally, 37.9% of patients in group 1 exhibited a whirlpool sign compared to 3 patients in group 2 (p=0.338).

Conclusion

The diagnosis of ovarian torsion continues to be a subject of debate within the medical community. However, a notable difference in size between the ovaries seems to serve as a dependable indicator of ovarian torsion in pediatric patients.