Doppler and gray‐scale sonographic classification of adnexal torsion

Auslender, R.; Shen, O.; Kaufman, Y.; Goldberg, Yael; Bardicef, Mordechai; Lissak, Arie; Lavie, Ofer

doi:10.1002/uog.6369

Cited by 26 publications

(16 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lee et al [9] reported that 12/28 patients with surgically proven torsion that showed no blood flow within the twisted pedicle had necrotic ovaries at surgery. More recently, Auslender et al [8] classified 17 cases of adnexal torsion: class 1 (9 cases) - coiling with arterial and venous ovarian blood flow, conservative approach; class 2 (5 cases) - coiling with arterial ovarian flow but no venous flow, surgical intervention required; class 3 (3 cases) - true strangulation with no ovarian blood flow, urgent surgical intervention. Our Doppler studies were focused on the presence of flow within the ovary and not on the ‘coiling' sign in the pedicle.…”

Section: Discussionmentioning

confidence: 99%

“…The salient clinical findings associated with adnexal torsion characteristically include acute onset of unilateral lower abdominal pain and a palpable tender adnexal mass [2,3,4,5,6]. The tentative diagnosis of adnexal torsion is supported by ultrasonographic and Doppler studies which demonstrate an adnexal mass and absent or diminished blood flow [7,8,9]. The incidence of adnexal torsion is higher in women aged <30 years [2].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, a small study suggested that Doppler studies may be of value in differentiating between ischemic and non-ischemic torsion, advocating a conservative approach when ischemia is not suspected [8]. A literature review did not reveal corroborating studies or other studies aimed to differentiate between ischemic and non-ischemic torsion.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Are Ultrasonographic Findings Suggestive of Ovarian Stromal Edema Associated with Ischemic Adnexal Torsion?

Yaakov¹,

Zohav²,

Kapustian³

et al. 2015

Gynecol Obstet Invest

View full text Add to dashboard Cite

Objective: To study whether sonographic findings suggestive of ovarian stromal edema are associated with tissue ischemia in patients with adnexal torsion. Methods: A study of 79 patients with adnexal torsion was performed. Patients were divided into an ischemic group, in which the twisted adnexa were seen as blue or black, and a non-ischemic group, in which the adnexa retained normal color and appeared viable. Clinical and ultrasonographic findings, specifically the presence of ultrasonographic signs suggestive of ovarian stromal edema, were compared between the two groups. Results: Of the 79 patients with torsion, in 44 (55.7%) the adnexa appeared ischemic at surgery. The presence of ischemia was not associated with age, pregnancy, duration of pain, vomiting or findings at physical examination. There was no significant difference between the ischemic and the non-ischemic group in the proportion of patients with signs of ovarian stromal edema (59 vs. 40%, p = 0.11), in the proportion of patients with absent/diminished stromal Doppler flow (36 vs. 28%, p = 0.12%) or in the proportion of patients with both signs of stroma edema and absent/diminished stromal Doppler flow (20 vs. 12%, p = 0.36). Conclusion: Ultrasonographic signs of ovarian stromal edema do not assist in differentiating between ischemic and non-ischemic adnexal torsion.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Are Ultrasonographic Findings Suggestive of Ovarian Stromal Edema Associated with Ischemic Adnexal Torsion?

Yaakov¹,

Zohav²,

Kapustian³

et al. 2015

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…Also, it is reported that spiral rotation of the ovarian pedicle and fallopian tube can be detected as a ‘whirlpool sign’ by using gray scale and color Doppler ultrasound 7 . Another article has reported that the type of ovarian blood flow seen on Doppler examination can predict ovarian severity as follows 8 . Arterial and venous blood flow within the ovary is consistent with the normal‐sized or mildly enlarged ovary; only arterial blood flow within the ovary is consistent with the enlarged ovary with normal color or mild discoloration; neither arterial nor venous blood flow within the ovary is consistent with ischemia and necrosis.…”

Section: Discussionmentioning

confidence: 99%

Acute abdomen due to ovarian congestion: A fallopian tube accompanied by a paratubal cyst, coiling tightly round the ovary

Kaido

Kikuchi

Kanasugi

et al. 2012

J of Obstet and Gynaecol

View full text Add to dashboard Cite

We experienced an unreported rare case with an adnexal mass causing severe acute abdomen during pregnancy. A 30-year-old Japanese pregnant woman was transported to our hospital for her right lower abdominal pain at 30 weeks of gestation. Magnetic resonance imaging and ultrasound demonstrated a cyst measuring 3-4 cm in diameter adjacent to the right ovary, and a parovarian cyst was considered to be the most probable diagnosis. We strongly suspected torsion of the ovarian pedicle or fallopian tube in conjunction with her clinical symptoms. Laparotomy revealed that the elongated right fallopian tube accompanied by a paratubal cyst was coiling tightly 2.5 times round the right ovary, causing apparent congestion and enlargement of the right ovary. Soon after we released the congested right ovary from the coiling of the fallopian tube, the congestion subsided. The postoperative course was favorable, and pregnancy and delivery were uneventful.

show abstract

“…La utilidad de la ecotomografía pelviana con o sin doppler, está descrita en la literatura. Es importante mencionar que la presencia de flujos no descarta la torsión anexial y que el doppler puede fallar en el diagnóstico hasta en un 60% (28,29). En nuestra serie, el doppler no fue el elemento central en la evaluación de laboratorio, posiblemente debido a lo expresado anteriormente.…”

Section: Discussionunclassified

Manejo Laparoscópico De Quistes Ováricos Complicados O Persistentes Durante El Embarazo

Albornoz

et al. 2009

Rev. chil. obstet. ginecol.

View full text Add to dashboard Cite

RESUMENAntecedentes: El incremento en el hallazgo de quistes anexiales durante el embarazo sería el mayor uso de técnicas de reproducción asistida con hiperestimulación ovárica controlada. La complicación más frecuente sigue siendo la torsión anexial. Objetivo: Revisar el manejo de quistes anexiales complicados o persistentes, durante el embarazo, con resolución laparoscópica. Método: Revisión retrospectiva de 9 pacientes consecutivas, ingresadas al Departamento de Obstetricia y Ginecología Clínica Las Condes. Resultados: La edad gestacional de ingreso fue entre 5+5 y 27 semanas. Cinco casos fueron producto de fertilización asistida y cuatro espontáneos. Ocho (85,6%) embarazadas, ingresaron por dolor abdominal agudo. Otro caso ingresó a cirugía electiva por quiste ovárico persistente. Los quistes tenían entre 6 y 13 cm. En 5 se realizó sólo destorsión ovárica, en 1 ooforectomía y en 1 quistectomía. Se realizó punción, destorsión y fijación a ligamento útero ovárico, bilateral, en la otra paciente. Se registró un caso de fiebre en el postoperatorio. El alta hospitalaria fue a las 48 horas en 6 (67%), a las 72 en 2 y a las 96 en 1. El estudio biópsico diferido en 3 pacientes demostró: 1 quiste seroso paratubario, 1 quiste luteínico parcialmente hemorrágico y 1 infarto anexial. Todos los embarazos evolucionaron normalmente. Conclusión: Nuestra experiencia confirma que en el embarazo la laparoscopía es una buena opción al requerir una cirugía por quiste anexial complicado o persistente. PALABRAS CLAVE: Torsión anexial, laparoscopia, hiperestimulación ovárica, embarazo SUMMARYBackground: Recent reviews show an increase in the finding of adnexal cysts during pregnancy. One reason could be the use of assisted reproductive techniques with controlled ovarian hyperstimulation. Objective: To review the experience in managing via laparoscopy complicated or persistent adnexal cysts during pregnancy. Method: Retrospective review of 9 consecutive patients, admitted at the Department of Obstetrics and Gynecology, Clinica Las Condes. Results: The gestational age was between 5+5 and 27 weeks. Five were the product of assisted fertilization and four spontaneous. Eight (85.6%) pregnant women were admitted by emergency room because of acute abdominal pain and another one went through elective surgery for persistent ovarian cyst. Preoperative diagnosis of the 8 patients admitted by emergency: adnexal cyst complicated with torsion in 6 (1 adnexal infarction) and 2 cases of acute abdomen. The cysts were between 6 and 13 cm. Type of surgery: in 5, only detorsion; ovarian oophorectomy in 1 and cystectomy in one. Puncture, detorsion and bilateral fixation of uterine ovarian ligament, in another patient. One case required conversion to laparotomy with adnexectomy. Postoperative fever was observed in one patient. Discharge was at 48 hrs

show abstract

Doppler and gray‐scale sonographic classification of adnexal torsion

Abstract: Objective To propose, in cases with coiling of the ovarian vessels, a classification of severity of torsion based on

Cited by 26 publications

References 19 publications

Are Ultrasonographic Findings Suggestive of Ovarian Stromal Edema Associated with Ischemic Adnexal Torsion?

Are Ultrasonographic Findings Suggestive of Ovarian Stromal Edema Associated with Ischemic Adnexal Torsion?

Acute abdomen due to ovarian congestion: A fallopian tube accompanied by a paratubal cyst, coiling tightly round the ovary

Manejo Laparoscópico De Quistes Ováricos Complicados O Persistentes Durante El Embarazo

Contact Info

Product

Resources

About