Oophoropexy, hyperbaric oxygen therapy, and contrast-enhanced ultrasound after asynchronous bilateral ovarian torsion

Svensson, Jan F.; Larsson, Agneta; Uusijärvi, Johan; Sivers, Karin von; Kaiser, Sylvie

doi:10.1016/j.jpedsurg.2008.02.024

Cited by 21 publications

(22 citation statements)

References 13 publications

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“…This was also found in a study where 10% of the women with confirmed adnexal torsion had had intermittent abdominal pain prior to the diagnosis . De‐torsion of the ovaries without ovariopexy was successful in more than 90% of described cases, with the patient regaining ovarian function measured by normal ovarian blood flow, folliculogenesis, spontaneous conception or normal hormonal status in adolescents on follow‐up . Celik et al.…”

Section: Resultsmentioning

confidence: 67%

“…Seven studies described 47 pre‐menarcheal girls , and two had a mixed population that included 24 pre‐menarcheal girls . Both normal ovaries and ovaries with a long salpinx, mesosalpinx or meso‐ovarium and adnexal masses could twist, but the most common underlying pathology in pre‐menarcheal girls were cysts of different origin, often simple functional cysts such as lutein cysts, but also serous cystadenomas, hemorrhagic cysts, teratomas and dysembryoplastic tumors .…”

Section: Resultsmentioning

confidence: 99%

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Re‐torsion of the ovaries

Hyttel¹,

Bak

Larsen

et al. 2014

Acta Obstet Gynecol Scand

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The increasing use of de-torsion of the ovaries may result in re-torsion. This review addresses risk of re-torsion and describes preventive strategies to avoid re-torsion in pre-menarcheal girls, and fertile and pregnant women. We clinically reviewed PubMed, Embase, Trip and Cochrane databases. The main outcome measures were re-torsion and viability of ovary with fixation measures. A total of 38 publications including 71 girls, 363 fertile women, and 69 pregnant women were found to be relevant. All studies were case reports or case series, sometimes with non-randomized controls. The studies show considerable heterogeneity in design, population, management and outcome. Only four studies included more than 50 cases. In pregnancy the risk of re-torsion was as high as 19.5-37.5%; among fertile women it was 28.6%. Most articles concluded that fixation of the ovaries to the pelvic sidewall or plication of the ovarian ligament after torsion may prevent re-torsion. In one case a girl experienced re-torsion after ovariopexy. Based on observational studies it seems that de-torsion and fixation of the ovary is a safe procedure that usually ensures maintenance of ovarian function and reduces the risk of recurrence, especially when there are no ovarian cysts or adnexal masses.

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Section: Resultsmentioning

confidence: 67%

Section: Resultsmentioning

confidence: 99%

Re‐torsion of the ovaries

Hyttel¹,

Bak

Larsen

et al. 2014

Acta Obstet Gynecol Scand

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show abstract

“…In 2002, Özcan et al [5] reviewed the literature and added 2 of his own cases (summarized in Table 1). As seen in Table 1, there has since been 8 additional cases reported [13][14][15][16] of which 2 were synchronous torsions of bilateral ovarian dermoids [14,17]. Our case presents the first child with bilateral synchronous pediatric torsion of ovaries without distinct pathology such as an ovarian cyst or neoplasm.…”

Section: E20mentioning

confidence: 74%

Pediatric synchronous bilateral ovarian torsion: a case report and review of the literature

Dumont

Caccia

Allen

2011

Journal of Pediatric Surgery

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“…Immediate cystectomy on an ischemic oedematous and fragile ovary during the initial detorsion can further jeopardize the already compromised ovarian viability. 31 Svensson et al 32 suggested use of hyperbaric oxygen as an adjunct to improve perfusion. Styer and Laufer 33 suggested the bivalving procedure in the case of severely haemorrhagic and oedematous adnexa.…”

Section: Torsion Of Normal Ovarymentioning

confidence: 99%

Paediatric Ovarian Torsion- Salvaging the Unsalvageable

Vasudevan¹,

Sadiq²

2019

jebmh

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BACKGROUND Ovariectomy used to be the conventional treatment for ovarian torsion in the paediatric age group. A paradigm shift in the management of paediatric ovarian torsion was reported in recent years, with ovarian recovery documented with simple detorsion, even for cases which macroscopically appeared necrotic or gangrenous. Our study was undertaken to analyse the management and outcome after detorsion of twisted ovaries in children. METHODSA prospective study of 20 consecutive cases of paediatric ovarian torsions that presented in a tertiary level Paediatric Surgery Dept. from 2010 to 2014 was done. Neonatal and infantile cases were excluded. Pre-operative parameters (age, symptoms and duration, menarchal status, sonographic features, doppler assessment of flow, tumour markers, time to surgery from presentation at hospital) and per-operative parameters (site, size, appearance, colour and response to detorsion) were assessed. The cases were categorized into 3 groups-Group A-Detorsion with or without aspiration. Group B-Detorsion with immediate ovarian sparing cystectomy. Group C-Ovariectomy. Post-operatively, patients were followed up clinically and with sonograms. RESULTSIn all cases of Group A and B, the ovary could be salvaged as documented with sonograms, irrespective of the initial macroscopic appearance of the ovary. All cases in group B, where cystectomy was done along with the initial detorsion, had smaller ovaries in follow up sonograms. There were no cases of ovarian malignancy undergoing torsion. 55% of cases were that of normal ovary undergoing torsion. In ovarian torsions, where the size was more than 5 cms and/or volume of the involved side was more than 20 times that of the opposite normal ovary, 82% had an associated cyst/benign lesion at the time of torsion. CONCLUSIONSOvarian preservation should be the basic tenet of surgical approach irrespective of the pre-operative Doppler findings and intra-operative color of the twisted ovary.

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Oophoropexy, hyperbaric oxygen therapy, and contrast-enhanced ultrasound after asynchronous bilateral ovarian torsion

Cited by 21 publications

References 13 publications

Re‐torsion of the ovaries

Re‐torsion of the ovaries

Pediatric synchronous bilateral ovarian torsion: a case report and review of the literature

Paediatric Ovarian Torsion- Salvaging the Unsalvageable

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