Ovarian torsion causing bowel obstruction in a premature infant

Abstract

We report a case of 3-months-old infant with diagnosed complex ovarian cyst admitted to the hospital with acute onset of clinical signs of upper gastrointestinal tract obstruction. Urgent laparotomy was performed. A Treves' field mesenterial defect with herniation of small bowel loops and a complex ovarian cyst with torsion was identified. Unexpectedly, the Fallopian tube as a strangulation band of the herniated bowel loops was discovered within the mesenterial defect. During the operation bowel loops reduction, mesenterial defect closure and left adnexectomy due to presence of necrotic changes was done. Perioperatively, coincidental malrotation with Ladd's bands were found, thus Ladd's procedure was performed. Finally, right small paraovarian simplex cyst was fenestrated. The following postoperative course was uneventful. To the best of our knowledge, it is the first case report described in literature proposing unusual combination of congenital anomalies leading to acute intestinal obstruction.

Keywords

• Small bowel obstruction
• Treves' field
• Internal hernia
• Ovarian cyst
• Malrotation