Adnexal torsion: diagnosis by using Doppler sonography.

Rosado, William; Trambert, Michael; Gosink, B B; Pretorius, D H

doi:10.2214/ajr.159.6.1442394

Cited by 119 publications

(67 citation statements)

References 2 publications

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“…Unilateral torsion associated with an adnexal mass is seen more commonly although cases of torsion of normal adnexa have been reported [11]. The mechanism of adnexal torsion is not known conclusively; however, various theories, such as the presence of a long tube, sudden valsalva maneuver [12], pelvic congestion [13], and autonomic dysfunction of tubal peristalsis, have been suggested [14]. Factors that could possibly influence the occurrence of fallopian tube torsion are divided into two types: internal and external (Table 5).…”

Section: Discussionmentioning

confidence: 99%

Management of adnexal torsion by laparoscopic approach

et al. 2012

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The study aimed to evaluate the effectiveness and safety of laparoscopic management of adnexal torsion. Early minimal invasive surgical management of adnexal torsion with the main emphasis on an organ-preserving procedure can safely be recommended. Although the incidence of adnexal torsions has increased, the morbidity rate has declined due to safer diagnostics and operative strategies. This is a retrospective case-control study (Canadian Task Force classification II-3) of 33 cases of adnexal torsion over an 11-year period (December 1999-September 2010) in a gynecologic endoscopy unit of a university hospital. Interventions include early diagnostic laparoscopy and utmost protection of the surrounding tissue. Thirty-three cases of laparoscopically managed adnexal torsions were analyzed. Fifty-two percent had conservative organ-sparing procedures, while 48 % underwent resection of ovary, tube, or both. The mean operating time was 69.2 min. There were no complications or conversions to laparotomy. The most common predisposing factor was an adnexal mass with symptoms of pain. Torsion on the right tube is more common than on the left. Laparoscopic surgery is an effective, safe, and feasible method in the diagnosis and treatment of adnexal torsion.

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Section: Discussionmentioning

confidence: 99%

Management of adnexal torsion by laparoscopic approach

et al. 2012

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“…5 The ultrasound findings of ovarian torsion may change depending on the duration and degree of torsion (Complete or incomplete) and the presence or absence of ovarian mass. 6,7 The other adnexal pathologies like endometriosis, hemorrhagic cysts, ectopic pregnancy, pelvic inflammatory disease form complex adnexal mass and make it difficult to differentiate sonographically. 4,8,9 All age groups are susceptible to develop adnexal torsion though it is commonly seen in reproductive women.…”

Section: Discussionmentioning

confidence: 99%

Adnexal torsion-five-year retrospective study

Abraham

Arunachalam

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Adnexal torsion is one of the gynecologic emergency conditions requiring prompt diagnosis and surgical treatment to save the ovarian function. This retrospective study is intended to analyze the clinical manifestations and treatment in a tertiary care center.Methods: This is a retrospective study Case records during five-year period of February 2012-2017 in PSG Institute of Medical Sciences and research, Coimbatore, India.Results: Adnexal torsion was seen in all age groups and commonly in reproductive age. It was seen in few pregnant patients also. Lower abdominal pain of acute onset associated with nausea and vomiting was the commonest clinical feature. Ovarian cyst and PCOD were the common risk factors predisposing torsion. Though ultra sound was the common modality used, the diagnosis was done based on strong clinical suspicion with surgical confirmation. The ovaries were preserved in some patients of reproductive age group.Conclusions: Adnexal torsion is one of the gynecologic emergencies. The symptoms and signs are nonspecific and may not have a confirmatory lab or imaging study. Hence a strong clinical suspicion followed by prompt surgical management in both pregnant and non -pregnant patients of any age group saves the ovary and further complications.

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“…[3][4][5][6][7][8] The "classic" sonographic findings are not specific to torsion and include the presence of multiple follicles rimming an enlarged ovary, [8][9][10][11][12][13] which reflect the ovarian congestion and edema described earlier. Other findings include an abnormal position of the ovary (anterior to the uterus, in the pouch of Douglas, or on the contralateral side), ovarian masses, and the presence of pelvic fluid.…”

Section: Discussionmentioning

confidence: 99%

Medial or Lateral Location of the Whirlpool Sign in Adnexal Torsion

Navve

Hershkovitz

Zetounie

et al. 2013

J of Ultrasound Medicine

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Objectives The whirlpool sign is used as a sonographic marker for adnexal torsion. The aims of this study were to describe the location of the whirlpool sign (lateral or medial to the ovary) and to evaluate the clinical importance of the location. Methods : Thirty patients with a confirmed surgical diagnosis of torsion and a positive whirlpool sign on sonography before surgery were included. We examined the sonographic clips of these patients. Classic signs of adnexal torsion were determined: ovarian edema, the presence of a mass, pelvic free fluid, and ovarian ischemia on Doppler imaging. The whirlpool sign was detected on grayscale and color Doppler sonography by moving the transducer to and fro along the axis of suspected torsion. Results Sixteen of 30 patients had right‐sided torsion. Of these, 7 had a lateral whirlpool sign. All 7 of these patients had an ovarian or paraovarian mass. Nine of these 16 patients had a medial whirlpool sign. Of these, 7 had an ovarian or paraovarian mass, and 2 had no mass. Of the 14 patients with left‐sided torsion, all had a medial whirlpool sign. Nine of 14 these patients had an ovarian or paraovarian mass, and 5 had no mass. The mean volume of the masses among cases with the lateral whirlpool sign was significantly greater compared to those with the medial whirlpool sign (304 versus 108 cm3; P = .035). In 25 of 30 cases, the torsed components included the ovary. Conclusions The lateral whirlpool sign is associated with enlarged masses in comparison to the medial whirlpool sign. This finding indicates the need to search meticulously for the lateral whirlpool sign in cases with enlarged masses to decide whether to operate on these patients emergently.

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Adnexal torsion: diagnosis by using Doppler sonography.

Cited by 119 publications

References 2 publications

Management of adnexal torsion by laparoscopic approach

Management of adnexal torsion by laparoscopic approach

Adnexal torsion-five-year retrospective study

Medial or Lateral Location of the Whirlpool Sign in Adnexal Torsion

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