WOFAPS 2025 8th World Congress of Pediatric Surgery

Fatma Thamri, Senda Houidi, Arije Zouaoui, 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

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Purpose

Ovarian torsion presents low incidence in children and unspecific clinical presentation, therefore the diagnostic delay is rather common. Traditionally, necrotic appearance has been synonymous of oophorectomy, however the current trend defends ovary preservation. The aim of our study is to present our experience in conservative management of ovarian torsion.

Methods

We performed a retrospective study of girls operated for ovarian torsion, from January 2015 to December 2024. We studied the cases of patients with enlarged, friable and black-bluish ovary, having detorsion and adnexal sparing. Post-operative evolution and Ultrasound were assessed and analyzed.

Results

Thirty-Seven were included, among home, 9 girls had a black ovary after detorsion. Mean age was 9 years (6-13 years). The time interval between the onset of symptoms to surgery was 50 hours (2-3 days). In all cases the damaged ovary was right, and the average size was 5.2 cm. Tumor markers were normal. Laparoscopic approach was performed in all cases. On follow-up, almost all patients studied had functioning ovarian tissue. With an average follow-up of two years, ultrasound showed normal-looking ovaries in 6 cases and a diminished micro-follicular ovary in 3 cases.

Conclusion

Conservative management with untwisting the ovary allows that macroscopically nonviable ovaries could be recovered. However, an exhaustive and long-term follow-up is required to confirm the outcome.