Acute ovarian torsion in an infant: diagnostic clues on supine and decubitus abdominal radiographs confirmed by ultrasound

Acute ovarian torsion is an uncommon yet important diagnostic consideration in any female pediatric patient presenting with acute abdominal pain. A 2-month-old infant presented to the emergency department with a several-day history of constipation. Evaluation with plain radiographs demonstrated a subtle yet persistent soft tissue mass in the right pelvis. Follow-up ultrasound revealed characteristic findings for ovarian torsion and subsequent salpingo-oophorectomy was performed confirming the diagnosis. Acute ovarian torsion is an uncommon and frequently overlooked diagnosis in female infants presenting with gastrointestinal or urinary tract symptoms. Careful assessment of plain radiographic findings may aid in the further management of this difficult diagnosis in female infants. Ultrasound is recommended to confirm the diagnosis.