Ovarian Torsion: Presentation and Management in a Pediatric Patient

Nguyen, Katie P.; Valentino, William L.; Bui, D.; Milestone, Honey

doi:10.1155/2022/9419963

Cited by 4 publications

(7 citation statements)

References 23 publications

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“…One of these conditions is ovarian cancer. Acute appendicitis, ovarian cyst rupture, tubal ovarian abscess, pelvic inflammatory disease, and ectopic pregnancy are some of the other disorders that fall under this category [4,6] it is not unusual for ovarian cyst torsion to be difficult to detect due to clinical characteristics that have a low sensitivity and specificity. This can be frustrating for the patient.…”

Section: Discussionmentioning

confidence: 99%

“…The torsion of the ovarian pedicle causes the limitation of venous drainage and arterial blood flow, which leads to edema, an inflammatory reaction, ischemia, and eventually necrosis of the tissue. Torsion of the ovarian pedicle can be prevented by avoiding torsion [2,3,4] . The patient initially complaints of abrupt abdominal pain when they arrive at the hospital.…”

Section: Introductionmentioning

confidence: 99%

“…Doppler and grayscale sonography are the primary imaging modalities that are utilised for these individuals during the initial assessment. Other imaging modalities, such as colour Doppler, may also be utilised [3,4] .…”

Section: Introductionmentioning

confidence: 99%

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Ovarian torsion: A case series

C¹,

Sudhir²

2022

Int. J. Clin. Obstet. Gynaecol.

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Aims and Objectives:The aim of the study was to analyse risk factors, surgical outcomes, ovarian salvage rate, and mass histopathology. Objectives of the study was to draw the attention to the clinical, sonographic, surgical, and pathological signs and symptoms and characteristics of histologically proven ovarian torsion instances. Method: This study took place at the Department of Obstetrics and Gynecology, Kamineni Institute of Medical Sciences in Narketpally from July 2021 to July 2022. Retrospective analyses of demographic, clinicopathological, surgical, and sonographic data were performed on 16 patients with ovarian torsion who underwent surgery. All instances of sudden, severe, acute abdomen pain were looked at clinically and radiologically. After receiving the findings, emergency surgery was performed. Result: 31 was the mean age. Pelvis or abdominal pain was the major complaint in our investigation. A pre-existing ovarian mass is a significant risk factor for torsion. 60% had emergent exploratory laparotomy, 40% laparoscopic operation. 40% had cystectomy, 60% oophorectomy. Most prevalent was serous cystadenoma. Conclusion:Study shows that ovarian torsion causes abdominal or pelvic pain. Pre-existing ovarian mass is a risk factor for torsion. Ovarian torsion can develop at any age. Ultrasound imaging is most frequently used to assess torsion but confirmative diagnosis by intraoperative finding. To preserve ovarian tissue, act quickly.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Ovarian torsion: A case series

C¹,

Sudhir²

2022

Int. J. Clin. Obstet. Gynaecol.

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“…The patient's cyst displaces the ovarian tissue on Doppler scans, with no visible follicles or vascular activity. The whirlpool signal is a particular yet seldom encountered Doppler diagnosis of twisted blood vessels in the pedicle [12].…”

Section: Case Presentationmentioning

confidence: 99%

Ovarian Salvation in Pediatric Ovarian Torsion: A Case Report

Brahmantara¹,

Hardjoto

Setiawan

et al. 2022

EJMED

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An accurate diagnosis of ovarian torsion is critical because of the possible long-term impact on fertility. Ovarian torsion is challenging to diagnose due to a generic clinical presentation and a wide range of imaging appearances. The pediatric group is even more challenging to serve since young people typically fail to define their symptoms or provide a thorough medical history. Imaging is, therefore, critical in diagnosing ovarian torsion in young people. A fourteen-year-old female went to the emergency room complaining of acute left lower quadrant stomach discomfort. She arrived hemodynamically stable with an acute abdomen. Transabdominal ultrasound revealed a primarily anechoic formation spanning 5x5 cm from the left adnexa, with the intact arterial flow but limited lymph node involvement. Transabdominal ultrasound revealed a primarily anechoic formation up to 5x5 cm in size from the left adnexa, with the maintained arterial flow but restricted venous outflow. The patient had an exploratory laparotomy, which revealed a left ovarian cyst (5.2 cm 5.4 cm 2.2 cm) with the left adnexa twisted 720°. The torsion was repaired with a simple cystectomy. Pathology results indicated that the cystic contents were benign. This juvenile patient's ovarian function was preserved thanks to an accurate diagnosis and prompt surgical surgery.

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“…У жодної пацієнтки, передусім у дівчат передменструального віку, не було потреби проводити гінекологічне обстеження, що збігається з рекомендаціями інших дослідників [6,16], водночас, за даними E. Ashwal зі співавторами (2015), у дівчат пост менструального віку гінекологічне обстеження є необхідним [3].…”

Section: матеріали та методи дослідженняunclassified

Treatment of children with adnexal torsion

Чайківська¹,

Hyzha²,

Pereyaslov³

2022

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The diagnosis of adnexal torsion is challenging due to the absence of specific symptoms that can determine the postponing of surgery, and, as the consequence, the development of necrotic changes at adnexa. Today, the surgical treatment of patients with this pathology shifting to the ovary-sparing surgery (detorsion) despite to the presence of necrotic changes during surgery. By that, the question of the choice of the method of treatment in case of adnexal torsion still under debate between pediatric surgeons and gynecologists. Purpose - to summarize the own experience in the treatment of patients with adnexal torsion. Materials and methods. This study based on the results of the treatment of 73 patients with adnexal torsion, which were operated at 2010-2022 years. Diagnosis was established on the results of clinical investigation and ultrasonographic (US) data. It was performed 74 surgical procedures (one patient was operated on twice), among them 57 (77%) by laparoscopic and 17 (23%) open approach (laparotomy). It was 49 (66.2%) ovary-sparing procedures (detorsion with or without cystectomy) and 25 (33.8%) - adnexectomy. Results of the study were evaluated by the statistical program StatPlus: mac, AnalystSoft Inc. (version v8). Results. Mean age of patients was 11.50.5 years. Abdominal pain syndrome (in 100%) and vomiting (in 49.3%) were the main clinical appearances. Unilateral ovaria enlargement and peripheral displacement of follicles were the most frequent US findings. The absence of the blood flow was revealed in 39.5% and the whirlpool sign in 11.6% of patients. Among of all patients, simple torsion confirmed in 24.3%, while the torsion caused by cyst or dermoid tumors, revealed in 75.7% of patients. Detorsion only was performed in 24.3% of patients and in 42.5% of patients it was supplemented by cystectomy. Adnexectomy was performed in 32.2% of patients. Conclusions. The diagnosis of adnexal torsion should be considered in all females with acute abdominal pain syndrome. Ultrasonography with or without Doppler is the first-line imaging modality. Laparoscopic detorsion, simple or supplemented by cystectomy, is the method of choice in the treatment of patients with adnexal torsion. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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Ovarian Torsion: Presentation and Management in a Pediatric Patient

Cited by 4 publications

References 23 publications

Ovarian torsion: A case series

Ovarian torsion: A case series

Ovarian Salvation in Pediatric Ovarian Torsion: A Case Report

Treatment of children with adnexal torsion

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