Retrospective study of ultrasound defined adnexal masses in adolescent girls: a case series

Abstract

Ovarian torsion is an uncommon but critical surgical emergency in adolescent girls, often presenting as acute lower abdominal pain that can mimic other abdominal conditions. Prompt diagnosis and timely surgical intervention are essential to prevent irreversible adnexal damage and preserve fertility. Objective was to analyse the clinical presentation, diagnostic findings, surgical management, and histopathological outcomes of ultrasound-defined adnexal masses in adolescent girls. This retrospective study was conducted on 18 adolescent girls aged 11–19 years diagnosed with adnexal masses at Vijaya Hospital, Chennai, from 2019 to 2025. Data regarding demographic details, symptoms, imaging findings, intraoperative observations, management procedures, and histopathological diagnoses were reviewed. The mean age of presentation was 17 years. Most patients presented with acute-onset right-sided lower abdominal pain of less than 48 hours’ duration, often associated with vomiting. Ultrasound was the primary diagnostic modality, though the presence of vascular flow did not exclude torsion. Laparoscopic detorsion with cystectomy was the most frequent management approach. Histopathological evaluation predominantly showed benign lesions such as serous, mucinous, and para-ovarian cysts. Follow-up imaging revealed either normal or polycystic ovaries in most cases. Ovarian torsion should be considered in all adolescent girls presenting with sudden lower abdominal pain. Ultrasound remains the initial diagnostic tool, but surgical exploration confirms the diagnosis. Conservative management with detorsion is recommended to preserve ovarian function and future fertility.