ASYNCHRONOUS BILATERAL ADNEXAL TORSION IN A PREPUBERTAL GIRL - A CASE-REPORT AND REVIEW OF THE WORLD LITERATURE

A 7-year-old girl who presented with progressive abdominal pain associated with nausea, vomiting, and fever underwent laparotomy for a presumed periappendiceal abscess. Exploration revealed a torsed left adnexa with hemorrhagic necrosis and a normal appendix. The adnexa was removed along with the appendix. Two years later, the patient presented with increasing right lower abdominal pain, nausea, and fever. Physical examination revealed a tender, soft, midpelvic mass that produced pain upon palpation. Adnexal torsion was diagnosed at laparotomy and the right adnexa was twisted 720° in a clockwise fashion. A right salpingo-oophorectomy was performed and the uterus was retained. The patient did well postoperatively.