Ovarian Torsion: Can We Operate Earlier?

Abstract

A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To reduce the time period between emergency admission and operation, patients who were operated due to ovarian torsion, were evaluated in terms of clinical symptoms, diagnostic methods and treatment. We aimed to evaluate the management of the patient suspected ovarian torsion accompanied review of the literature. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Retrospective case review. Thirty-six patients who underwent laparoscopic ovarian torsion operation between 2010-2014 years were included in this study. R Re es su ul lt ts s: : Surgically proved 36 cases of ovarian torsion were included in the study. The mean age of the patients was 27 years. Acute abdominal pain, vomiting and nausea were the main presenting symptoms. All the patients had abdominal tenderness and 13 of them (36%) had positive peritoneal signs in abdominal examination. None of the patients had fever. Adnexal mass was detected in almost all patients in vaginal ultrasound. Transabdominal ovarian color Doppler duplex ultrasound imaging results were obtained 28 patients which were performed by radiology physician. From these, 14(50%), 8(28%) and 6(22%) patients' ovarian duplex doppler imaging reported absent, decreased and normal blood flow respectively. Eight patients' doppler duplex ultrasound files were not able to find in the patients' file. All the patients underwent laparoscopic operation. Thirty of whom (83%) treated conservatively and 6 (16%) oophorectomy was performed. The median time interval from emergency service admission to operation was 9 hours and 20 minutes. This time period ranged 44 minutes and 25 hours 30 minutes. C Co on nc cl lu us si io on n: : Ovarian torsion is hard to diagnose. The delay in diagnosis is the major obstacle for treatment. The biggest restriction is the lack of an appropriate imaging method or biochemical marker. To reduce the time between surgery and admission to the hospital, ovarian torsion diagnosis has to be preoccupied by any low abdominal pain synchronous with vomiting and detected abdominopelvic mass in bedside ultrasound. Laparoscopic conservative treatment should be considered as the first. To prevent the recurrence, cystectomy or adnexal fixation could be performed. K Ke ey y W Wo or rd ds s: : Torsion abnormality; ultrasonography, doppler, duplex; laparoscopy Ö ÖZ ZE ET T A Am ma aç ç: : Acil servise başvuru ile operasyon arasındaki zamanı kısaltmak için, over torsiyonu nedeniyle opere olan hastalar klinik bulgu, tanı yöntemi ve tedavi şekilleri açısından değerlendirilmiştir. Over torsiyonu şüphesi olan hastaların yönetiminin, literatür eşliğinde değerlendirilmesi amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em m--l le er r: : Retrospektif vaka sunumu. 2010-2014 yılları arasında laparoskopik over torsiyonu cerrahisi yapılmış 36 hasta çalışmaya dahil edilmiştir. B Bu ul lg gu ul la ar r: : Cerrahi olarak kanıtlanmış 36 over torsiyonu vakası çalışmaya dahil edilmiştir. Hastaların ortalama yaşı 27 yıldır. Akut karın ağrı...

Perioperative Outcomes in Pregnant Women Who Underwent Surgery for Adnexal Torsion

“…The adnexal detorsion (AD) surgery constitutes 2.7% of all gynecological emergent surgeries during pregnancy and may affect women of all ages, particularly during the reproductive period. [1][2][3] The AT is rather rare during pregnancy and its incidence is between 1 and 5 in every 10,000 patients, among cases with spontaneous pregnancy. 4,5 Following the implementation of the assisted reproductive techniques (ART), the number and size of the follicular cysts increase along with the dramatic increase in the risk of torsion.…”

“…The adnexal detorsion (AD) surgery constitutes 2.7% of all gynecological emergent surgeries during pregnancy and may affect women of all ages, particularly during the reproductive period. 1 2 3 …”