Adnexal torsion in adolescents. Case report

Adnexal torsion is an acute pathology that represents 3% of gynecological emergencies in adolescents. In this pathology, the vitality of the ovary and its adnexa can be compromised, being a well-timed diagnosis crucial for anatomical preservation. With the improvement of diagnosis techniques, it has been possible to demonstrate that adnexal detorsion progressively leads to the functional recovery of the oocytes, allowing them to maintain their reproductive capacity, even when the presence of ischemic adnexal torsion is present. Conservative treatments, commonly by laparoscopy, are recommended as the intervention of choice. This work shows a specific clinical case as an example of the difficulty in determining the diagnosis. The presence of unspecified signs and symptoms commonly leads to the misidentification of the adnexal torsion with other acute abdominal pain conditions. Despite having imaging support, the low sensitivity of color Doppler for the detection of ovarian torsion has been described since, in 60% of cases, the adnexal torsion can be found without alterations in the tissue due to the supplementary vascularization that can camouflage a suitable diagnosis of this pathology.