Risk Factors, Symptoms, and Treatment of Ovarian Torsion in Children: The Twelve-Year Experience of One Center

Tsafrir, Ziv; Azem, Foad; Hasson, Joseph; Solomon, Efrat; Almog, Benny; Nagar, Hagith; Lessing, Joseph B.; Levin, Ishai

doi:10.1016/j.jmig.2011.08.722

Cited by 84 publications

(61 citation statements)

References 28 publications

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“…Nurith et al, [17] Ziv tsafrir et al, [24] Our Study As the time interval between symptoms to surgery is prolonged, the rate of ovarian conservation is reduced [26]. The time interval from admission to the surgery in our patients was 24h (median) and 38 cases (54.3%) had conservative surgery.…”

Section: Risk Factorsmentioning

confidence: 57%

“…Laparoscopy is the recommended procedure for adnexal torsion as it gives better visualization, shorter hospital stay, fewer postoperative complications, small scar, less blood loss and analgesia requirement [6,24]. Laparoscopy was done in 81.7% of the torsion cases in our study and was found to be a reliable method [Table/ Fig-8].…”

Section: Risk Factorsmentioning

confidence: 77%

“…But recent studies suggest a conservative approach of detorsion with ovarian cystectomy for benign tumours [24]. Salpingoophorectomy is preferred in post menopausal women, suspected malignancy and non-viable ovary [3].…”

Section: Risk Factorsmentioning

confidence: 99%

“…Various studies have shown that even though the adnexa appear blue or black, it does not imply that it is nonviable and hence detorsion is done to retain the ovarian function [3,24,25].…”

Section: Risk Factorsmentioning

confidence: 99%

See 3 more Smart Citations

Five Year Retrospective Case Series of Adnexal Torsion

Nair

Joy

Nayar

2014

JCDR

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Section: Risk Factorsmentioning

confidence: 57%

Section: Risk Factorsmentioning

confidence: 77%

Section: Risk Factorsmentioning

confidence: 99%

“…Various studies have shown that even though the adnexa appear blue or black, it does not imply that it is nonviable and hence detorsion is done to retain the ovarian function [3,24,25].…”

Section: Risk Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Five Year Retrospective Case Series of Adnexal Torsion

Nair

Joy

Nayar

2014

JCDR

View full text Add to dashboard Cite

“…In 2012, Ziv Tsafir et al 34 conducted a retrospective study to assess risk factors, clinical findings and mode of diagnosis and management in premenarchal children with surgically verified ovarian torsion. Twenty-two cases of ovarian torsion were identified.…”

Section: Ovarian Torsionmentioning

confidence: 99%

Adnexal torsion-symptoms, diagnosis and management: a review of literature

Jain¹,

Manchanda²,

Chithra³

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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Imaging in gynecological disease (20): clinical and ultrasound characteristics of adnexal torsion

Moro

Bolomini

Sibal

et al. 2020

Ultrasound in Obstet & Gyne

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Objectives To describe the clinical and ultrasound characteristics of adnexal torsion. Methods This was a retrospective study. From the operative records of the eight participating gynecological ultrasound centers, we identified patients with a surgically confirmed diagnosis of adnexal torsion, defined as surgical evidence of ovarian pedicle, paraovarian cyst and/or Fallopian tube twisted on its own axis, who had undergone preoperative ultrasound examination by an experienced examiner, between 2008 and 2018. Only cases with at least two available ultrasound images and/or videoclips (one grayscale and one with Doppler evaluation) were included. Clinical, ultrasound, surgical and histological information was retrieved from each patient's medical record and entered into an Excel file by the principal investigator at each center. In addition, two authors reviewed all available ultrasound images and videoclips of the twisted adnexa, with regard to the presence of four predefined ultrasound features reported to be characteristic of adnexal torsion: (1) ovarian stromal edema with or without peripherally displaced antral follicles, (2) the follicular ring sign, (3) the whirlpool sign and (4) absence of vascularization in the twisted organ. Results A total of 315 cases of adnexal torsion were identified. The median age of the patients was 30 (range, 1–88) years. Most patients were premenopausal (284/314; 90.4%) and presented with acute or subacute pelvic pain (305/315; 96.8%). The surgical approach was laparoscopic in 239/312 (76.6%) patients and conservative surgery (untwisting with or without excision of a lesion) was performed in 149/315 (47.3%) cases. According to the original ultrasound reports, the median largest diameter of the twisted organ was 83 (range, 30–349) mm. Free fluid in the pouch of Douglas was detected in 196/275 (71.3%) patients. Ovarian stromal edema with or without peripherally displaced antral follicles was reported in the original ultrasound report in 167/241 (69.3%) patients, the whirlpool sign in 178/226 (78.8%) patients, absent color Doppler signals in the twisted organ in 119/269 (44.2%) patients and the follicular ring sign in 51/134 (38.1%) patients. On retrospective review of images and videoclips, ovarian stromal edema with or without peripherally displaced antral follicles (201/254; 79.1%) and the whirlpool sign (139/153; 90.8%) were the most commonly detected features of adnexal torsion. Conclusion Most patients with surgically confirmed adnexal torsion are of reproductive age and present with acute or subacute pain. Common ultrasound signs are an enlarged adnexa, the whirlpool sign, ovarian stromal edema with or without peripherally displaced antral follicles and free fluid in the pelvis. The follicular ring sign and absence of Doppler signals in the twisted organ are slightly less common signs. Recognizing ultrasound signs of adnexal torsion is important so that the correct treatment, i.e. surgery without delay, can be offered. Copyright © 2020 ISUOG. Published by John Wiley &...

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Risk Factors, Symptoms, and Treatment of Ovarian Torsion in Children: The Twelve-Year Experience of One Center

Cited by 84 publications

References 28 publications

Five Year Retrospective Case Series of Adnexal Torsion

Five Year Retrospective Case Series of Adnexal Torsion

Adnexal torsion-symptoms, diagnosis and management: a review of literature

Imaging in gynecological disease (20): clinical and ultrasound characteristics of adnexal torsion

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