To present a case of a 12-year-old girl who developed ovarian torsion following GnRH analogue treatment and to highlight the diagnostic challenges associated with this rare complication.
Approach:
Patient Background: A 12-year-old post-menarchal female with short stature received GnRH analogue therapy for height augmentation.
Clinical Presentation: The patient developed acute abdominal pain, emesis, and diarrhea one week after the injection.
Diagnostic Imaging: Pelvic ultrasonography and CT imaging revealed significant bilateral ovarian enlargement and suspected adnexal torsion.
Surgical Intervention: Exploratory laparotomy confirmed left ovarian torsion and cyst formation, leading to a left salpingo-oophorectomy.
Key Findings:
The patient developed acute-onset abdominal pain and was diagnosed with bilateral ovarian enlargement and left ovarian torsion.
In this case, GnRH analogue therapy was associated with rapid ovarian hyperstimulation and subsequent torsion.
Post-operative recovery was unremarkable, and GnRH analogue therapy was permanently discontinued.
Interpretation:
This case emphasizes the need for clinician vigilance regarding the risk of ovarian complications in post-menarchal females receiving GnRH analogue therapy.
Limitations:
The case study is based on a single patient, limiting generalizability of the findings.
Further research is needed to understand the prevalence of such complications in larger cohorts.
Conclusion:
Prompt recognition and surgical intervention were crucial to prevent long-term consequences for fertility in this case of adnexal torsion.
