Successful laparoscopic surgery for 14-month-old infant with ovarian torsion
A 14-month-old girl weighing 10.4 kg visited our clinic with a 3-day history of irritability and vomiting. She have had no special medical history and other symptoms except for poor oral intake prior to this presentation. Furthermore, there were no abnormal findings in physical examination or laboratory tests except that her white blood cell count was within the upper limit (11,760/up; normal range, 4,000-1,2000/up). Transabdominal ultrasonography (USG) showed the enlarged right adnexa suggestive of ovarian torsion (). Magnetic resonance imaging (MRI) for pelvic organs revealed an edematous right ovary that was enlarged to 3.6 cm with decreased enhancement (). Thus, we planned to perform an emergent laparoscopic surgery for confirmative diagnosis and surgical treatment.\nAfter insufflation using a Verres needle, we inserted 5-mm diameter cannulas into the umbilicus, and two 3-mm ancillary cannulas were inserted into both lower quadrants of the abdomen (). During laparoscopy, abdominal pressure was maintained below 8 mmHg, and the edematous change of the right fallopian tube was found because the tube was twisted without knot formation or ovarian cysts (). Thus, we only untwisted the right adnexa using 3-mm diameter forceps, and completed all procedures without complications or bleeding. The operating time was 25 minutes, and her irritability decreased after surgery. She was discharged from the hospital 2 days after surgery. There was no abnormal finding when she visited our department 10 days after surgery.