“…They speculated that the occurrence of ovarian hernias might be associated with a shorter round ligament. Scheier et al ( 15 ) suggested that premature birth (before Nuck canal closure), excessive length of the fallopian tube leading to ovarian mobility, and increased intra-abdominal pressure (including deep breathing or straining during bowel movements) could increase the risk of ovarian hernias in infants.…”
Section: Discussionmentioning
confidence: 99%
“…Additionally, there have been reported cases of pediatric patients with ovarian hernias, where postoperative procedures ensured the complete preservation of the ovaries ( 15 , 29 ). However, in some studies, some children with ovarian torsion underwent oophorectomy.…”
ObjectiveTo explore the clinical value of ultrasound examination in evaluating the presence of ovarian torsion in female infants with inguinal ovarian hernia.MethodsWe conducted a retrospective analysis of 91 cases of ovarian hernia diagnosed by ultrasonography at our institution. Among them, 6 cases were identified as ovarian strangulation, while 85 cases were classified as non-ovarian strangulation. All cases underwent high-frequency ultrasound examination. We analyzed whether there were differences in the associated factors between the two groups and compared the disparities in the urgency of surgery between the two groups.ResultsSignificant differences were observed between the ovarian strangulation group and the non- strangulation group in terms of ovarian volume, ovarian blood flow, and the presence of incarceration. The need for emergency surgery was significantly associated with the presence of incarceration and ovarian torsion.ConclusionUltrasound has good clinical value in diagnosing ovarian hernia and determining the presence of ovarian strangulation. It can assist clinical physicians in determining the timing of surgery for children with ovarian hernia.
“…They speculated that the occurrence of ovarian hernias might be associated with a shorter round ligament. Scheier et al ( 15 ) suggested that premature birth (before Nuck canal closure), excessive length of the fallopian tube leading to ovarian mobility, and increased intra-abdominal pressure (including deep breathing or straining during bowel movements) could increase the risk of ovarian hernias in infants.…”
Section: Discussionmentioning
confidence: 99%
“…Additionally, there have been reported cases of pediatric patients with ovarian hernias, where postoperative procedures ensured the complete preservation of the ovaries ( 15 , 29 ). However, in some studies, some children with ovarian torsion underwent oophorectomy.…”
ObjectiveTo explore the clinical value of ultrasound examination in evaluating the presence of ovarian torsion in female infants with inguinal ovarian hernia.MethodsWe conducted a retrospective analysis of 91 cases of ovarian hernia diagnosed by ultrasonography at our institution. Among them, 6 cases were identified as ovarian strangulation, while 85 cases were classified as non-ovarian strangulation. All cases underwent high-frequency ultrasound examination. We analyzed whether there were differences in the associated factors between the two groups and compared the disparities in the urgency of surgery between the two groups.ResultsSignificant differences were observed between the ovarian strangulation group and the non- strangulation group in terms of ovarian volume, ovarian blood flow, and the presence of incarceration. The need for emergency surgery was significantly associated with the presence of incarceration and ovarian torsion.ConclusionUltrasound has good clinical value in diagnosing ovarian hernia and determining the presence of ovarian strangulation. It can assist clinical physicians in determining the timing of surgery for children with ovarian hernia.
“…Accurate diagnosis can be achieved by combining physical and US findings. In particular, US is useful for prompt diagnosis and appropriate management of patients in an emergent situation and point of care setting [36,37].…”
Aim: There is a concern that the differential diagnosis of a groin mass depends on a physicians’ subjective judgment and experience. We aimed to clarify the significance of US in the diagnosis of a groin mass.Material and methods: This retrospective study included 1,898 patients who underwent US examination of a groin mass. Physicians’ diagnoses were compared with US-based diagnoses. Furthermore, the incidence of asymptomatic contralateral hernia was analyzed. The frequency of unnecessary surgery in patients with and without preoperative US was compared. In 1,451 patients who underwent surgery with preoperative US, the preoperative US classification was compared with surgical diagnosis.Results: Of 1,805 patients diagnosed with an inguinal hernia by physicians, 190 (10.5%) exhibited no US findings of inguinal hernia. US revealed asymptomatic contralateral hernia in 13.3% of the 1,543 patients in whom a physician detected unilateral inguinal hernia. The frequency of unnecessary surgery was significantly associated with preoperative US (1/1451; 0% vs. 2/351, 0.6%; p=0.0382). The overall US diagnostic accuracy for the inguinal hernia type was 92.7%.Conclusions: US imaging of a groin mass can help avoid unnecessary surgery, detect latent inguinal hernia, and guide surgical planning.
“… 7 In infants, the location of the torsed ovary may be in an inguinal hernia sac ( Figure 1 ). 8 In children over a year of age, ovarian torsion comprises 1.3% of acute surgical diagnoses. 9 Figure 1 An inguinal ovarian hernia.…”
Ovarian torsion is defined as twisting of the ovary around an axis consisting of its vascular pedicle, the infundibulopelvic ligament and the tubo-ovarian ligament, and can occur in females of any age. Torsion can be a result of ovarian mass causing asymmetry and subsequent torsion, or can be spontaneous. While ovarian torsion is a surgical emergency, early diagnosis and treatment can preserve ovarian viability even if necrosis is seen operatively. Presentation classically involves sudden onset severe abdominal pain and vomiting but diagnostic delay can follow subtler presentations. Diagnosis is most commonly based on sonographic findings, but advanced imaging such as CT or MRI may be required if sonography is not diagnostic. Treatment is surgical, with ovarian preservation preferred in almost all cases. In this review, I present the most recent evidence on epidemiology, diagnosis, and management of pediatric ovarian torsion, with a focus on point-of-care ultrasound for the emergency care provider.
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