Recurrent Ovarian Torsion in a Premenarchal Girl Managed With Laparoscopic Round Ligament Oophoropexy: A Case Report.

Ovarian torsion is an uncommon but important cause of acute abdominal pain in the pediatric population and may occur even in the absence of an underlying ovarian mass. Recurrent torsion is rare and poses a significant therapeutic challenge, with no clear guidelines regarding optimal management or fixation technique. We report the case of a 12-year-old premenarchal girl with recurrent torsion of the left ovary, experiencing four episodes over a four-month period despite repeated laparoscopic detorsion and preservation of ovarian viability. During the most recent episode, laparoscopy revealed a left ovary twisted four times around its vascular pedicle. Following detorsion, oophoropexy was performed, and the ovary was fixed to the round ligament of the uterus with careful identification of the ureter. The postoperative course was uneventful. This case highlights the importance of early recognition, ovarian preservation, and individualized surgical decision-making while also emphasizing the need to consider potential implications for future fertility when selecting the appropriate surgical technique.