Ovarian preservation and prognosis in adnexal torsion surgery — a retrospective analysis

Weng, Xiu-Lan; Xie, Xi; Liu, Chaobin; Yi, Jingsong

doi:10.5603/gp.2020.0066

Cited by 6 publications

(4 citation statements)

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“…The percentage of cases of adnexal torsion when the affected organ needs to be resected varies significantly between studies and can range from 5% to 67% depending on the study (1,(4)(5)(6)(7). We found that a long duration of symptoms due to delayed presentation to the hospital can increase the risk of losing an organ (P=0.021), which has already been mentioned by other authors (32), again confirming that a precise diagnosis and management strategy are vitally important for preventing complications, especially infertility. R. A. Saberi et al reported that adnexal sparing surgery was more common in teaching hospitals, patients <13 years of age, and those from high-income households (33).…”

Section: Discussionsupporting

confidence: 85%

Adnexal Torsion in Adolescents – a Retrospective Analysis from a Tertiary Centre in Latvia

Gurmane,

Lidaka

2023

CEJP

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Objective - To review the data of cases of adnexal torsion in the paediatric population in a national level centre in Latvia and examine the pitfalls of diagnostic and therapeutic strategies.Methods - A retrospective review of medical records was performed on 61 cases of suspected and/or confirmed adnexal torsion in a national level paediatric centre.Results - In 85.5% of cases the initial diagnosis was made correctly. The age of the patient was a significant contributor to a shorter time until surgery (P=0.016). Abdominal pain was the most common symptom (90.6%), followed by nausea (58.5%) and vomiting (52.8%). Only 62.3% of the torsion patients had an elevated WBC and 69.4% had no elevated body temperature. The shorter the duration of symptoms, the more likely it was that the organ salvage procedure was performed (P=0.021). The sensitivity of ultrasound for the correct diagnosis was 71.4%. In almost a third of the torsion cases, no pelvic lesion was detected on ultrasound (26.5%). When ultrasound suspected torsion, the time before operation was significantly shorter (P<0.001), the presence of blood flow in the ovary extended the time until surgery (P=0.026). Organ-sparing surgery was performed in 73.6% of the cases.Conclusion - Medical professionals should not exclude the diagnosis of adnexal torsion in the absence of fever or leucocytosis, as well as in the case of normal adnexa on ultrasound. A delay in surgery increases the risk of irreversible ischemic damage leading to organ loss.

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Section: Discussionsupporting

confidence: 85%

Adnexal Torsion in Adolescents – a Retrospective Analysis from a Tertiary Centre in Latvia

Gurmane,

Lidaka

2023

CEJP

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“…[1][2][3] However, recent studies have shown that conservative management with detorsion alone does not appear to increase postoperative complications compared with oophorectomy, even in the setting of a necrotic-appearing ovary. [3][4][5][6][7][8][9][10][11] Therefore, ovarian conservation is now considered the standard of care for adnexal torsion. 3,7,8,[12][13][14] Despite the safety of ovarian conservation, oophorectomy remains common in the management of torsion.…”

Section: Resultsmentioning

confidence: 99%

Changing Practices in the Surgical Management of Adnexal Torsion

Ryles

Hong

Andy

et al. 2023

Obstetrics &Amp; Gynecology

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“…Geimanaite et al [20] conducted a long-term follow-up study on 20 girls and found that conservative surgical management of ovarian torsion in children was safe and preserved normal ovarian anatomy and function after detorsion and retention of the ovary in the abdominal cavity. Additionally, literature reviews [21][22][23] support ovarian detorsion as the preferred option for managing ovarian torsion over oophorectomy. Based on the present findings, it is postulated that anticoagulant therapy may be a viable option to restore ovarian blood supply and reduce complications in cases where OVT is detected during surgery.…”

Section: Discussionmentioning

confidence: 99%

Group B Streptococcus infection-induced ovarian vein thrombosis identified during cesarean section: A case report and a literature review

Zhou

Chao-man

et al. 2023

Medicine

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Rationale: Ovarian vein thrombosis (OVT) is a rare yet potentially life-threatening condition associated with thromboembolic events. Group B Streptococcus (GBS) is a type of β-hemolytic Gram-positive bacterium known for asymptomatic colonization in the lower genital and gastrointestinal tracts. Here we reported a 35-year-old multiparous woman with gestational diabetes who suffered from placental abruption, stillbirth, OVT, septic shock, and renal failure due to severe GBS infection.Patient concerns: A 35-year-old woman with gestational diabetes presented with acute and sustained lower abdominal cramping, vaginal bleeding, and fever at 35 gestational weeks.Diagnoses: Based on preoperative ultrasound and intraoperative findings, the patient was diagnosed with placental abruption, intrauterine fetal demise, and right OVT. GBS was cultured from the amniotic fluid obtained during cesarean section. Interventions:The patient underwent a right adnexectomy during a cesarean section and received intravenous antibiotics. Subsequently, an ultrasound-guided uterine curettage was performed due to recurrent fever.Outcomes: After a prolonged course of intravenous antibiotics for over a month, the patient recovered and was discharged from the hospital.Lessons: This case underscores the need for early initiation of anticoagulant protocols in cases of OVT, particularly when GBS infection is identified as a predisposing factor. Further research and awareness are warranted to better understand the relationship between GBS infection and OVT and to optimize management strategies in such cases.

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Ovarian preservation and prognosis in adnexal torsion surgery — a retrospective analysis

Cited by 6 publications

References 0 publications

Adnexal Torsion in Adolescents – a Retrospective Analysis from a Tertiary Centre in Latvia

Adnexal Torsion in Adolescents – a Retrospective Analysis from a Tertiary Centre in Latvia

Changing Practices in the Surgical Management of Adnexal Torsion

Group B Streptococcus infection-induced ovarian vein thrombosis identified during cesarean section: A case report and a literature review

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