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Analysis of the risk of ovarian torsion in 49 consecutive pediatric patients treated at a single institution
  1. Koshiro Sugita1,
  2. Takafumi Kawano1,
  3. Mukai Motoi1,
  4. Toshihiro Muraji1,2,
  5. Shun Onishi1,
  6. Tomoe Moriguchi1,
  7. Koji Yamada1,
  8. Waka Yamada1,
  9. Ryuta Masuya1,
  10. Seiro Machigashira1,
  11. Kazuhiko Nakame1,
  12. Tatsuru Kaji1 and
  13. Satoshi Ieiri1
  1. 1Department of Pediatric Surgery, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima, Japan
  2. 2Department of Pediatric Surgery, Kirishima Medical Center, Kirishima, Japan
  1. Correspondence to Dr Satoshi Ieiri; sieiri{at}


Purpose An early diagnosis of ovarian torsion is sometimes difficult due to variable clinical symptoms and non-specific imaging findings. We retrospectively reviewed patients with pediatric ovarian masses manifesting torsion.

Methods Fifty-eight ovarian masses (55 episodes) in 49 non-neonatal patients treated from April 1984 to March 2017 were retrospectively analyzed. The Mann-Whitney U test and Fisher’s exact test were used for the statistical analysis.

Results The median age of these 55 episodes was 10.5 years old (range 1.0–23.0). Thirty-three patients presented with abdominal pain. Forty-five tumors and 13 cystic masses were resected and diagnosed pathologically (50 benign and 8 malignant). Torsion was identified in 15 cases (25.9%) at operation. The torsion masses were all benign, and 8 ovaries (53.3%) were successfully preserved. Comparing the torsion cases with the non-torsion cases, only the white cell count was significantly higher in the torsion cases (p=0.0133) and in the patients presented with abdominal pain (p=0.0068). The duration of abdominal pain was significantly shorter in ovary preserved cases than in oophorectomy cases.

Conclusion The white blood cell may be a helpful indicator of the presence of torsion as well as the need for surgery.

  • ovarian mass
  • torsion
  • cystic
  • pathology
  • preservation

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  • Contributors KS drafted this manuscript. TK, MM and TM revised the manuscript. SO, TM, KY, WY and KS collected the data. RM, SM, KN and KS analyzed and interpreted the data.TK, KS and SI designed this study. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval The Ethics Committee of Kagoshima University (No 27-119).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available upon reasonable request.

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