Adnexal Torsion in Children

Chang, Yi Jung; Yan, Dah Chin; Kong, Man‐Shan; Wu, Chieh‐Tsai; Chao, Hsun Chin; Luo, Chih Cheng; Hsia, Shao Hsuan

doi:10.1097/pec.0b013e318180fd8b

Cited by 45 publications

(36 citation statements)

References 17 publications

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“…Ovarian volume can also influence the tendency for an ovary to torse because 83% of torsed ovaries in our study had US measurements of 5 cm or larger. Individual anatomy may play a role in those cases without a pathologic lead point because the length of the fallopian tube and suspensory ligaments can influence ovarian mobility and subsequent vascular compromise [6,14,15]. Our observed preferential sidedness of torsion on the right is in keeping with the expected 3:2 ratio and has been attributed to the relative mobility of the cecum allowing for more ovarian movement, in comparison to the fixation of the sigmoid colon [9,13,16,17].…”

Section: Discussionsupporting

confidence: 61%

See 1 more Smart Citation

Cannot exclude torsion—a 15-year review

Oltmann

Fischer

Barber

et al. 2009

Journal of Pediatric Surgery

217

155

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Section: Discussionsupporting

confidence: 61%

“…These tests are not definitive in the diagnosis of ovarian torsion but function to exclude other etiologies [1]. Ultrasound is currently the best imaging modality but cannot definitively rule out, or in, ovarian torsion [3][4][5][6]. The addition of duplex imaging has not positively impacted the sensitivity in predicting ovarian torsion.…”

mentioning

confidence: 93%

Cannot exclude torsion—a 15-year review

Oltmann

Fischer

Barber

et al. 2009

Journal of Pediatric Surgery

217

155

View full text Add to dashboard Cite

“…The universal presenting symptom of adnexal torsion is abdominal pain, which may be episodic [32]. Unfortunately, presenting symptoms of pain, nausea, and emesis are nonspecific and can delay diagnosis, with acute appendicitis being the most common differential diagnosis [33].…”

Section: Ovarian Torsionmentioning

confidence: 99%

Adnexal Masses in Pediatric and Adolescent Females: A Review of the Literature

Eskander

Bristow

2011

Curr Obstet Gynecol Rep

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Adnexal masses are uncommon in the pediatric and adolescent population. The differential diagnosis includes ovarian lesions, tubal or paratubal lesions, nongynecologic lesions, and lesions related to infection or pregnancy. Presenting symptoms vary and may include acute abdominal pain, mass effect, and less commonly, precocious puberty and vaginal bleeding. Most of these lesions represent benign pathology, but malignant lesions are identified in a small subset of patients, and appropriate surgical and postoperative management is essential. It is important for clinicians caring for these patients to understand the differential diagnosis of an adnexal mass, to facilitate correct management (whether surgical or nonsurgical) and necessary referrals where appropriate. This review explores the etiologies, presenting symptoms, and appropriate management options for pediatric and adolescent patients with adnexal masses. There are few clinical trials guiding the management of these patients, and existing data comprise primarily case series and retrospective studies.

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“…Its role as a predictor of torsion, however has elicited similar controversy. [6][7][8][9][10][11][12][13] In our study The Doppler findings were normal in patients with hemorrhagic cyst however Doppler examination was not done in patients with complex adnexal mass and Dermoid cyst. Laparoscopic approach was offered to all patients in our study except one where the patient was antenatal at 10 weeks of gestation.…”

Section: Discussionmentioning

confidence: 98%

“…The use of Ultrasonography in the diagnosis of ovarian torsion was demonstrated to have low specificity. 10 The search for a better modality of imaging in the diagnosis of Ovarian Torsion led to the suggestion of Doppler flow studies used to evaluate compromise in arterial or venous blood flow to the affected ovary. Its role as a predictor of torsion, however has elicited similar controversy.…”

Section: Discussionmentioning

confidence: 99%

Adnexal Torsion - Management and Review of Literature

Shrivastava¹,

Apte²,

Chanchlani³

2014

jemds

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BACKGROUND:Ovarian torsion presents as acute abdominal pain and early surgical management is required to prevent further adnexal damage. It accounts for 3% of all cases of acute abdominal pain in adult women. As signs and symptoms can mimic other acute abdominal conditions, the preoperative diagnosis often remains a challenge for primary care physicians. AIMS AND OBJECTIVES: To study the characteristics of adnexal torsion and factors influencing adnexal preservation. MATERIAL AND METHODS: All 14 patients were admitted in a tertiary endoscopic surgical unit with the complaints of pain in abdomen, nausea and vomiting of varying duration. The minimum duration of symptoms was 3 days and a maximum of 1 year. All patients were evaluated by ultrasound examination preoperatively. The time interval between the onset of symptoms and definitive surgery varied from 3 days to one year. Laparoscopic approach was offered to all patients except one where the patient was antenatal at 10 weeks of gestation. RESULTS: Out of 14 patients the youngest patient was a neonate 28 days old and oldest was 68 years of age. Most patients (n=9) were between 10 to 30 years of age. Intra operatively complete torsion (torsion of both ovary and fallopian tube) was found in 9 cases, 3 were torsion of hydrosalpinx and one case was torsion of a paraovarian cyst. One case was torsion of the adnexa in antenatal period. Adnexal congestion and edema was the most common finding (n=6) simulating hemorrhagic cyst. One patient the oldest in series age 68 years had torsion of an ovarian mass which was histologically confirmed as mucinous cystadenoma. Two patients had ovarian dermoid where ovary was salvaged in one by doing cystectomy and in the other a salpingoophorectomy was performed. In one patient it was torsion of parovarian cyst where cyst wall excision was performed. In antenatal at 11 weeks gestation a mini laparotomy was performed under epidural analgesia and detorsion was performed. In all 4 patients who had hydrosalpinx (n=3) and parovarian cyst (n=1), a salpingectomy and cyst excision was performed respectively. In rest with complete torsion (n=9, excluding fetal adnexal torsion) ovarian preservation was possible in 4 patients (44.45%) and 5 patients (55.55%) required oophorectomy. CONCLUSION: Adnexal torsion affects all ages of women and ovarian preservation is possible, if detorsion is possible. Delay in diagnosis prevents ovarian preservation. Though limited by small sample size it indicated that ovarian debulking may not be needed and detorsion relieves the venous congestion and edema. Laparoscopic approach remains the gold standard for the management of adnexal torsion and enables quick recovery.

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Adnexal Torsion in Children

Cited by 45 publications

References 17 publications

Cannot exclude torsion—a 15-year review

Cannot exclude torsion—a 15-year review

Adnexal Masses in Pediatric and Adolescent Females: A Review of the Literature

Adnexal Torsion - Management and Review of Literature

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