Combining point-of-care ultrasound with physical examination in a pediatric emergency department of ovarian torsion: A case report.

Abstract

Background: Point-of-care ultrasound (POCUS) is the use of portable ultrasound devices by trained healthcare professionals to diagnose and monitor medical conditions directly at the patient's bedside, such as in emergency settings. We described a case where POCUS use, in Pediatric Emergency Department, allowed an early diagnosis and timely management in the surgical department, with a favorable outcome for child. Therefore we write this case because it is desirable to popularize ultrasound as the fifth pillar of clinical examination especially in Emergency Department.

Case summary: A 13-year-old girl with acute gastrointestinal symptoms, such as vomit and abdominal and lumbar pains. Upon physical examination, the patient had localized abdominal pain in the left lower quadrant. Ultrasonography performed at the bedside revealed an enlarged left ovary with an irregular structure containing a 3 cm cyst. These findings raised suspicion of ovarian torsion. The child transferred to Gynecology Surgery Unit, where she was taken emergently to the operating room.

Conclusion: It is desirable to spread POCUS in emergency settings where it allows a significant saving of time in patient management.