Clinical characteristics and surgical treatment evaluation of ovarian torsion in children and adolescents

You Zhiheng; Shi Zhengfeng; Zhao Zheng

doi:10.3760/j.issn.1673-4777.2026.07.018

Abstract：Objective To explore the clinical characteristics and surgical treatment of ovarian torsion in children and adolescents,and to evaluate the changing trend of surgical strategies.Methods A retrospective analysis was performed on the clinical features,surgical modalities and pathological findings of children and adoles-cents with a confirmed diagnosis of ovarian torsion who underwent surgical treatment in Shanxi Children's Hospital from January 2017 to December 2024.Results A total of 158 surgically confirmed cases of ovarian torsion in children and adolescents were enrolled.The age distribution presented a bimodal pattern,with peaks in infancy and menarche period.The main clinical manifestations included abdominal pain,nausea and vomiting,accounting for 88.0％(139/158),38.6％(61/158)and 31.0％(49/158)respectively.Most neonatal cases were identified as abdominal masses during prenatal examination and confirmed surgically after birth.Ultrasound was the primary imaging modality;among 151 patients receiving ultrasound examination,117 cases(77.5％)were preoperatively diagnosed with ovarian torsion.The application rate of laparoscopy increased from 27.3％(3/11)in 2017 to 87.0％(20/23)in 2024,while the oophorectomy rate decreased from 72.7％(8/11)in 2017 to 26.1％(6/23)in 2024.Most cases of ovarian torsion complicated with adnexal masses were of benign pathological types.Conclusion Ovarian torsion in children and adolescents is more common in early infancy and around puberty with non-specific clinical symptoms.Transabdominal and pelvic ultrasound serves as the main diagnostic method.Ovarian torsion combined with ovarian masses is frequently encountered in this population,and most associated masses are benign lesions.The intraoperative oophorectomy rate has gradually declined,while the application rate of laparoscopy has remained at a relatively high and stable level in recent years.