Pediatric ovarian torsion: case series and review of the literature

Poonai, Naveen; Poonai, C; Lim, Rodrick; Lynch, Tim

doi:10.1503/cjs.013311

Cited by 76 publications

(77 citation statements)

References 24 publications

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“…Abdominal pain is a serious complaint for toddlers as their symptoms consist of just crying, obviously when mother has the experience she would be aware of the seriousness of such complaint and hurry to see a doctor, in children over 5-8 years of age, lower abdominal symptoms and following taking a proper history, reliable clinical examination and other investigations, the common deferential diagnosis include either Mesenteric Adenitis, or Acute Appendicitis etc. When in female toddler around the age of two years , abdominal symptoms should be regarded as more serious since almost always acute appendicitis can be ruled out, and involvement of adnexal should be kept in mind despite its rarity [3], It can occur at any age, for almost 70% of cases In women aged less than 20 years [4]. Accordingly a quick and confident diagnosis is required to save the adnexal structures from infarction, this can't be achieved unless be thought of.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

MOJS

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Introduction: Sudden abdominal pain in toddlers is a taxing challenge, the only symptoms that a two years old toddler can present are crying in pain, it represent a great problem for young mother who never experienced such event before, as a little girl she can't complain verbally except crying and occasionally vomiting. Case presentation:We present a case of a two years old girl suffered from severe abdominal pain associated with vomiting. She was referred to our clinic for surgical consultation, with three days history of abdominal pain, vomiting .Following her visit to the general practitioner, Full blood count revealed notable leukocytosis 24800, with normal urinalysis, the abdomen was rigid, with guarding mainly in the right lower quadrant with absent bowel sounds, since the child was extremely agitated and un cooperating, abdomen X ray , Echo, CTor MRI were omitted. Despite its rarity we were in doubt of adnexal involvement. Through a 25 mm, lower abdomen Rt sided skin crease Incision, the diagnosis of Rt sided Ovary and Uterine Tube Hemorrhagic infarction was confirmed clinically, the appendix appeared to have reactive inflammation. Resection of Rt Uterine Tube and Ovary, as well as appendectomy performed. Her post-operative course was uneventful. The Histology report confirmed the Diagnosis of Hemorrhagic Infarction of Rt Tube and Ovary, Appendix Reactive Inflammation and benign Lymphoid Hyperplasia. Conclusion:Abdominal pain in toddler should be regarded as real emergency, and in females. Torsion of Ovary and Tube should always be kept in mind in the deferential diagnostic process.

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Section: Discussionmentioning

confidence: 99%

Untitled

2017

MOJS

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“…Most laboratory findings are normal, although a slight leukocytosis may be observed [17 && ]. Occasionally, a sterile pyuria is described [18]. High serum levels of tumor markers such as CA125 and alpha-fetoprotein may be correlated…”

Section: Clinical Presentationmentioning

confidence: 98%

“…It has been demonstrated that a black-bluish ovary, which does not change its color during surgery, is no evidence of necrosis, and recovery is still likely to occur [4 && ,17 && ,34]. Most ovaries demonstrate normal follicular development on ultrasonography and normal Doppler flow after only 6 weeks [18]. If, unfortunately, the ovary appears atrophic on ultrasonography follow-up, a second look is necessary [34].…”

Section: Treatmentmentioning

confidence: 99%

Adnexal torsion in adolescents

Spinelli

Piscioneri

Strambi

2015

Current Opinion in Obstetrics &Amp; Gynecology

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A systematic review of physiopathology, clinical picture, and imaging of adnexal torsion is certainly useful to identify as soon as possible this emergency condition. An early identification and an adequate treatment are indispensable in order to achieve a proper outcome for the patient. The choice of the appropriate surgical approach can be challenging and should be made on the basis of an accurate evaluation of the ovarian lesion. Therefore, it would be useful to perform an intraoperative frozen section analysis in selected cases.

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“…In 2013, Naveen Poonai et al 21 performed a retrospective review of cases of ovarian torsion in paediatric population. They analyzed 13 patients and found a seven month child as their youngest case of ovarian torsion.…”

Section: Ovarian Torsionmentioning

confidence: 99%