Clinical characteristics of adnexal torsion in premenarchal patients

Herman, Hadas Ganer; Shalev, Amir; Ginat, Shimon; Kerner, Ram; Keidar, Ran; Bar, Jacob; Sagiv, Ron

doi:10.1007/s00404-015-3840-9

Cited by 19 publications

(9 citation statements)

References 35 publications

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“…It has been reported that most of the premenarchal ovarian torsion cases present with abdominal pain and vomiting similar to this case 10. In a study that analysed 16 cases of premenarchal ovarian torsion cases, it has been found that most of the cases had normal-size ovary (69.9%) 10. This is in contrary to our case where the ovary was enlarged in the absence of any cysts which could be due to the compensated hypertrophy.…”

Section: Discussioncontrasting

confidence: 69%

“…Paediatric ovarian torsion is a rare entity, and the estimated prevalence between 1–20 years of age is 0.005% compared with 2.5%–7.5% in the adult population 9. It has been reported that most of the premenarchal ovarian torsion cases present with abdominal pain and vomiting similar to this case 10. In a study that analysed 16 cases of premenarchal ovarian torsion cases, it has been found that most of the cases had normal-size ovary (69.9%) 10.…”

Section: Discussionsupporting

confidence: 56%

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Unilateral tubo-ovarian agenesis with contralateral adnexal torsion in a premenarchal girl

et al. 2018

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Unilateral adnexal agenesis is a rare entity. Most of these cases are reported in reproductive age group. A case of a 10-year-old premenarchal girl is reported who presented with acute abdominal pain and vomiting. BothUltrasonography (USG) and MRI suggested right ovarian mass with torsion. Laparoscopic evaluation revealed an enlarged right ovary with torsion and contralateral agenesis of uterine tube and left ovary. Detortion of the ovary and an ovarian fixation to the ovarian pedicle was done. This is the first reported case of a premenarchal girl presenting with an acute abdomen due to adnexal torsion along with contralateral tubo-ovarian agenesis.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionsupporting

confidence: 56%

Unilateral tubo-ovarian agenesis with contralateral adnexal torsion in a premenarchal girl

et al. 2018

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“…Laparoscopy has been proven to be a safe approach for the treatment of AT in nonpregnant women [ 8 ]. Recent reports have indicated that conservative surgery, i.e., detorsion with or without cystectomy, does not increase thromboembolic complications and favors ovarian function preservation [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study

Wang

Deng

2020

BMC Pregnancy Childbirth

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Background: Adnexal torsion during pregnancy is a gynecological emergency. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women. Methods: A retrospective study was conducted at a tertiary center between January 2008 and January 2018. Eighty-two pregnant women with surgically confirmed adnexal torsion were included. The clinical characteristics, ultrasound data, surgical interventions and pregnancy outcomes were analyzed. Results: The median age of the patients was 28 (range, 18-38) years. The median gestational age was 11 (range, 6-31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). The Doppler blood flow signal disappeared in 62.5% of the patients. Sixty-three (76.8%) patients underwent laparoscopy, and 29 (24.2%) underwent laparotomy. The median gestational age in patients undergoing laparotomy was higher than that in those undergoing laparoscopy (26 weeks vs 10 weeks, p < 0.001). Fifty-three (64.6%) patients underwent conservative surgery, with 48 detorsions and cystectomies, 2 detorsions and cyst fenestrations, 1 detorsion only and 2 salpingectomies only. Twenty-nine (25.4%) patients underwent unilateral salpingo-oophorectomy. There were no cases of postoperative thrombosis, spontaneous abortion or recurrence during the same pregnancy. Seven patients underwent simultaneous artificial abortion. One patient experienced intrauterine fetal death, and 74 patients had live births. Conclusion: Surgical intervention was required as soon as possible. Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function.

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“…Adnexal torsion in premenarchal patients occurs rarely, its symptoms are similar to older patients, but involves a normal adnexa in 69% of cases [6]. Compared with older women, premenarchal patients with adnexal torsion are more commonly found with normal ovarian volume [1, 2, 7].…”

Section: Discussionmentioning

confidence: 99%

Adnexal Torsion in Pediatric Age: Does Bolli’s Score Work? Report of Two Cases

Giambanco

Iannone

Borriello

et al. 2019

Case Reports in Obstetrics and Gynecology

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Adnexal torsion is a surgical emergency requiring early diagnosis in order to avoid demolitive surgery. Adnexal torsion's diagnosis could be very difficult in pediatric patients because children cannot explain symptoms accurately. Furthermore reproductive organs lie high in abdomen, causing unclear examinations findings. For reducing diagnostic mistakes or delay clinical and hematological criteria could be useful. No radiological criteria (CT or MRI) should be taken in count because of the costs and the required time. By combining clinical presentation in patients with OT three useful diagnostic variables have been identified: age, duration of pain, vomiting. Presence of vomiting, short duration of abdominal pain and high CRP levels have great predictive value for the diagnosis of adnexal torsion. In those patients an exploratory laparoscopy should be performed without any doubt and/or delay. These data may aid physicians in the evaluation of abdominal pain in premenarchal girls.

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Clinical characteristics of adnexal torsion in premenarchal patients

Abstract: Adnexal torsion in premenarchal patients is rare, presents similarly to older patients, but involves a normal adnexa in 69% of cases, therefore requiring a high index of suspicion in any premenarchal patient with acute onset abdominal pain.

Cited by 19 publications

References 35 publications

Unilateral tubo-ovarian agenesis with contralateral adnexal torsion in a premenarchal girl

Unilateral tubo-ovarian agenesis with contralateral adnexal torsion in a premenarchal girl

Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study

Adnexal Torsion in Pediatric Age: Does Bolli’s Score Work? Report of Two Cases

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