Case: Solid mass in the left Iliac fossa with acute abdomen

The patient was seen at my chamber in practice. The girl of 11 years presented with severe abdominal pain and intermittent fever of two days duration.
Menustartion yet not started.

On examination, moderate tenderness was present in the left iliac fossa but no mass could be palpated. The patient was admitted on emergency and given conservative treatment for Acute Abdomen. Later, on evaluation a solid mass of 5cmX 4 cm was found in the left Iliac fossa on ultrasonography.
The patient was improved on conservative treatment of antibiotic, fluid, antipyretic and analgesic.
The follow up X-ray also showed a solid mass pushed the uterus to upward and to the right.
Laparotomy was done. The mass was found to be of ovarian origin and brown in color.
The change of color and solidity of the mass is likely due to haemorrhage into the overy due to torsion of the ligament of the overy.