Myths in the Evaluation and Management of Ovarian Torsion

Robertson, Jennifer; Long, Brit; Koyfman, Alexander

doi:10.1016/j.jemermed.2016.11.012

Cited by 46 publications

(26 citation statements)

References 57 publications

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“…Laparoscopy has been proven to be a safe approach for the treatment of AT in nonpregnant women [ 8 ]. Recent reports have indicated that conservative surgery, i.e., detorsion with or without cystectomy, does not increase thromboembolic complications and favors ovarian function preservation [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study

Wang

Deng

2020

BMC Pregnancy Childbirth

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Background: Adnexal torsion during pregnancy is a gynecological emergency. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women. Methods: A retrospective study was conducted at a tertiary center between January 2008 and January 2018. Eighty-two pregnant women with surgically confirmed adnexal torsion were included. The clinical characteristics, ultrasound data, surgical interventions and pregnancy outcomes were analyzed. Results: The median age of the patients was 28 (range, 18-38) years. The median gestational age was 11 (range, 6-31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). The Doppler blood flow signal disappeared in 62.5% of the patients. Sixty-three (76.8%) patients underwent laparoscopy, and 29 (24.2%) underwent laparotomy. The median gestational age in patients undergoing laparotomy was higher than that in those undergoing laparoscopy (26 weeks vs 10 weeks, p < 0.001). Fifty-three (64.6%) patients underwent conservative surgery, with 48 detorsions and cystectomies, 2 detorsions and cyst fenestrations, 1 detorsion only and 2 salpingectomies only. Twenty-nine (25.4%) patients underwent unilateral salpingo-oophorectomy. There were no cases of postoperative thrombosis, spontaneous abortion or recurrence during the same pregnancy. Seven patients underwent simultaneous artificial abortion. One patient experienced intrauterine fetal death, and 74 patients had live births. Conclusion: Surgical intervention was required as soon as possible. Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function.

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Section: Introductionmentioning

confidence: 99%

Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study

Wang

Deng

2020

BMC Pregnancy Childbirth

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“…Torsion involving paratubal or paraovarian cysts has also been found [ 2 7 8 ]. Early diagnosis and surgery are essential to protect ovarian and tubal function and prevent severe morbidity [ 9 10 ].…”

Section: Introductionmentioning

confidence: 99%

A review of ovary torsion

2017

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Ovarian torsion is a rare but emergency condition in women. Early diagnosis is necessary to preserve the function of the ovaries and tubes and prevent severe morbidity. Ovarian torsion refers to complete or partial rotation of the adnexal supporting organ with ischemia. It can affect females of all ages. Ovarian torsion occurs in around 2%–15% of patients who have surgical treatment of adnexal masses. The main risk in ovarian torsion is an ovarian mass. The most common symptom of ovarian torsion is acute onset of pelvic pain, followed by nausea and vomiting. Pelvic ultrasonography can provide information on ovarian cysts. Once ovarian torsion is suspected, surgery or detorsion is the mainstay of diagnosis and treatment.

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“…Similarly, Taş and Yavuz found that 91% of their studied BONs were complicated with adnexal torsion in the reproductive age group [5]. In addition; Huang et al and Robertson et al concluded that most of the ovarian or adnexal torsion occurs in the reproductive age, and the presence of ovarian cyst or mass > 5 cm predisposes to ovarian torsion [10,11].…”

Section: Discussionmentioning

confidence: 95%

Clinical and pathological features of women with adnexal masses admitted as emergency cases to the Gynaecology Department of West Kazakhstan University

Adilgereyeva

Abdelazim

Zhurabekova

2019

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Aim of the study: To detect the clinical and pathological features of women with adnexal masses (AMs) admitted as emergency cases to the Gynaecology Department of West Kazakhstan University. Material and methods: A retrospective analysis of the data of women with AMs admitted as an emergency cases to the Gynaecology Department of West Kazakhstan University. The collected data include: age, age of menarche and age of menopause, presenting symptoms, admission criteria-either self-referral or refereed from another department, ultrasound findings, associated pregnancy, associated pathology of the female genital tract, and post-operative histological results of surgically excised AMs (gold standard). Results: 77.04% (245/318) of the studied AMs were found in the reproductive age group. The main causes for surgical intervention for the studied AMs was ruptured ovarian cyst in 27.1% or adnexal torsion in 9.7%. The available histological results of the surgically managed AMs showed the following: functional ovarian cyst in 36.2% (115/318), benign ovarian neoplasms (BONs) in 18.55% (59/318), and borderline malignant ovarian tumours in 0.63% (2/318). 44.34% of the studied AMs were associated with pregnancy, 49.3% with chronic tubo-ovarain diseases such as salpingo-oophoritis, 14.8% with cervical pathology and pelvic inflammatory diseases, 11.3% with uterine leiomyomas, and 4.4% with endometrial hyperplasia. Conclusions: AMs were more common in the reproductive age group (77.04%), and 44.34% of the studied AMs were associated with pregnancy. The main causes of surgical intervention for the studied AMs were ruptured ovarian cyst in 27.1% or adnexal torsion in 9.7%.

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Myths in the Evaluation and Management of Ovarian Torsion

Cited by 46 publications

References 57 publications

Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study

Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study

A review of ovary torsion

Clinical and pathological features of women with adnexal masses admitted as emergency cases to the Gynaecology Department of West Kazakhstan University

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