Case series of paediatric adnexal torsion: rare yet urgent entity

Mishra, Vineet; Hokabaj, Shaheen; Roy, Priyankur; Aggarwal, Rohina; Vyas, Bhumika; Mehta, Neha

doi:10.18203/2320-1770.ijrcog20164685

Cited by 4 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In case ovary after de-torsion has become friable and cystectomy is not possible then salpingooophorectomy should be performed as the last resort. 4…”

Section: Resultsmentioning

confidence: 99%

Cases of management of paediatric tubo-ovarian torsion

Bhandari¹,

Khemani

Mustafa

2019

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Ovarian torsion is the fifth most common cause of gynaecologic surgical emergency. It warrants early diagnosis as timely surgical management will avoid the further adnexal injury. In paediatric population, this is especially dangerous as the condition can go undiagnosed because of its rarity and nonspecific presentation. This leads to delay in surgical exploration and loss of ovarian function. In these cases, the ovary and often the ipsilateral fallopian tube twist with the vascular pedicle, resulting in vascular compromise. Unrelieved torsion leads to haemorrhagic infarction. We encountered 3 cases of ovarian torsion in paediatric age group during a period of 12 months. All cases presented with acute pain abdomen for 3-7 days period with loss of appetite and unable to pass motion with varied disappearance of pain. On ultrasound all the cases were diagnosed with ovarian cyst with torsion and underwent laparoscopic cystectomy. This case series is written just to show the results of de-torsion and conserving the fallopian tube and ovary after vascular damage. This type of conservative management may give chance to ovary to return to viability. This was seen in all 3 cases dealt by us on repeat scan on follow up. Even on de-torsion if ovary does not regain its colour immediately it should be conserved, and cystectomy should be performed rather than oophorectomy. Conservative surgery, in the form of ovarian de-torsion can be tried in cases of ischemia but if ovarian necrosis has occurred, then salpingo-oophorectomy is performed as the last resort.

show abstract

“…In case ovary after de-torsion has become friable and cystectomy is not possible then salpingooophorectomy should be performed as the last resort. 4…”

Section: Resultsmentioning

confidence: 99%

Cases of management of paediatric tubo-ovarian torsion

Bhandari¹,

Khemani

Mustafa

2019

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…Ultrasound is the best initial investigation as it is readily available, no radiation exposure and can differentiate from other common causes of acute abdominal pain. 10 CT scan and MRI imaging can be used to diagnose ovarian torsion if not confirmed on ultrasonography. Subacute ovarian haemorrhage and abnormal enhancement is usually seen as their characteristic patterns on CT scan and MRI.…”

Section: Discussionmentioning

confidence: 99%

“…Subacute ovarian haemorrhage and abnormal enhancement is usually seen as their characteristic patterns on CT scan and MRI. 10 Management can be conservative, which preserves the ovary. Conservative surgical options include detorsion and oophoropexy, which are favored presently in 28% to 45% cases.…”

Section: Discussionmentioning

confidence: 99%

Paediatric ovarian torsion: a case report and review of literature

Umang

Cheema

Khullar

et al. 2020

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Ovarian torsion is a surgical emergency, can result in ovarian loss, intra-abdominal infection and even death. Paediatric ovarian torsion is a rare condition, requires high clinical suspicion and prompt diagnosis. Diagnosis is a challenge since signs and symptoms are similar to those of other causes of acute abdominal pain such as appendicitis, gastroenteritis, urinary tract infection, renal colic or other conditions of acute abdominal and pelvic pain. Here, authors describe a case of a 4-year-old girl with a presentation of acute abdominal pain, treated empirically elsewhere. After investigations, a provisional diagnosis of ovarian torsion was made and patient was taken up for surgery. Intraoperatively, ovary was found to be necrosed. Detorsion was tried but ovary was unsalvageable. Right sided salpingectomy with oophorectomy was performed. Conservative surgery by laparoscopic detorsion can be tried in cases of ischemia but if necrosis has already set in, then salpingo-oophorectomy has to be performed.

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

Case series of paediatric adnexal torsion: rare yet urgent entity

Cited by 4 publications

References 10 publications

Cases of management of paediatric tubo-ovarian torsion

Cases of management of paediatric tubo-ovarian torsion

Paediatric ovarian torsion: a case report and review of literature

Untitled

Contact Info

Product

Resources

About