Neonatal ovarian torsion complicated by intestinal obstruction and perforation, and review of the literature

Cerine Jeanty, Elizabeth A. Frayer, Renee Page, Scott Langenburg

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

We present a case of neonatal ovarian torsion complicated by bowel obstruction and perforation and review the literature regarding the incidence of bowel obstruction in neonatal ovarian cysts, the presentation, and treatment. A term neonate was prenatally diagnosed with a cystic abdominal mass palpable on physical examination. A postnatal abdominal x-ray showed paucity of gas in the left hemiabdomen with rightward displacement of bowel loops. Exploratory laparotomy on day 2 of life revealed a large cystic mass in the left lower quadrant consistent with a torsed left ovary, an omental band causing strangulation of the bowel mesentery, and a perforation of the distal ileum. Our literature search revealed 19 reported cases of neonatal ovarian cysts resulting in bowel obstruction. Infants may present with a palpable abdominal mass, respiratory distress, as well as signs and symptoms of intestinal obstruction. Two mechanisms exist for bowel obstruction: adhesions caused by a torsed necrotic ovary and mass effect of a large ovarian cyst, often measuring 9 to 10 cm in diameter. Options to treat ovarian cysts include antenatal or postnatal aspiration, laparoscopy, and laparotomy. Cysts less than 4 to 5 cm can be observed, whereas operative intervention is indicated in symptomatic cases and in persistent or enlarging ovarian cysts.

Original languageEnglish (US)
Pages (from-to)e5-e9
JournalJournal of Pediatric Surgery
Volume45
Issue number6
DOIs
StatePublished - Jun 1 2010
Externally publishedYes

Keywords

  • Bowel perforation
  • Intestinal obstruction
  • Neonatal ovarian cyst complications
  • Neonatal ovarian torsion

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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