Pediatric ovarian torsion: a pictorial review

Ngo, Anh-Vu; Otjen, Jeffrey P.; Parisi, Marguerite T.; Ferguson, Mark; Otto, Randolph K.; Stanescu, A. Luana

doi:10.1007/s00247-015-3385-x

Cited by 54 publications

(56 citation statements)

References 35 publications

(56 reference statements)

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“…The increased incidence of pathology during adolescence is likely secondary to hormonal influence and gonadal growth resulting in an increased frequency of physiologic and pathologic masses. 7,15,29,30 Our pathology findings were consistent with other studies that showed that the most frequently encountered ovarian and tubal lesions were benign, such as paratubal cysts, cystic teratomas, and hemorrhagic/ follicular cysts. Oltmann and colleagues also showed a strong association between AT torsion and a pelvic mass larger than 5 cm.…”

supporting

confidence: 91%

“…The mechanism of torsion in women and girls with ovarian masses is likely related to the increased size and weight of the involved ovary. 6,7 Historically, the treatment for AT was oophorectomy on the basis of theoretical concerns, such as leaving a nonviable severely ischemic ovary that might lead to infection or return to the operating room, missing a malignancy, and/or potential for thromboembolism from untwisting ovarian vessels.…”

Section: Introductionmentioning

confidence: 99%

“…AT involving the ovary and tube is far more common than isolated torsion of the ovary or fallopian tube. 7,23 Tubal torsion is almost always associated with tubal pathology such as a hydrosalpinx or tubal cyst. 6,23 The incidence of isolated tubal or ovarian torsion in pediatric and adolescent patients is difficult to determine.…”

mentioning

confidence: 99%

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Adnexal Torsion in Children and Adolescents: A Retrospective Review of 245 Cases at a Single Institution

Adeyemi‐Fowode

Lin

Syed

et al. 2019

Journal of Pediatric and Adolescent Gynecology

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a b s t r a c tStudy Objective: Adnexal torsion (AT) requires urgent surgical intervention to preserve ovarian function. Historically, treatment for AT was oophorectomy because of concerns related to leaving a nonviable ischemic ovary. No published studies support these theoretical concerns and current literature supports conservative management. The aim of this study was to review the institutional outcomes for AT cases, including salvage rates and complications. Design, Setting, Participants, Interventions, and Main Outcome Measures: This study was approved by the institutional review board at Baylor College of Medicine. A retrospective chart review on cases of AT from 2007 to 2016 at a single Children's hospital was performed on the basis of International Classification of Diseases, 10th revision and Current Procedural Terminology codes. A standardized chart review form was used in data extraction. Statistical analysis was performed using SAS version 9.4 (SAS Institute). Results: Chart review identified 245 torsion cases in 237 patients. The mean age was 12.4 AE 3.29 years. Of the participants, 230 (94%) underwent minimally invasive laparoscopy with ovarian preservation in 233 (95%) of the cases. There were no complications due to detorsion of the affected adnexa. Intraoperatively, the right adnexa was affected in 134 (55%) cases and a lesion was noted in 193 (79%) cases, most commonly paratubal cysts and mature teratomas. The malignancy rate was low, noted only in 4/245 patients at (1.2%). Pediatric gynecology performed most of the cases (n 5 214; 87%). Conclusion: The findings of our study continue to support the conservative management of patients with AT.

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supporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Adnexal Torsion in Children and Adolescents: A Retrospective Review of 245 Cases at a Single Institution

Adeyemi‐Fowode

Lin

Syed

et al. 2019

Journal of Pediatric and Adolescent Gynecology

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“…Regarding torsed ovaries, the normal function has been shown able to be restored following detorsion 15. Oophorectomy should therefore be avoided except in cases of thromboembolism, peritonitis, and malignancy 6. Five hemorrhagic cysts were resected in the earlier period of this series.…”

Section: Discussionmentioning

confidence: 97%

Analysis of the risk of ovarian torsion in 49 consecutive pediatric patients treated at a single institution

Sugita

Kawano

Mukai

et al. 2019

World Jnl Ped Surgery

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PurposeAn early diagnosis of ovarian torsion is sometimes difficult due to variable clinical symptoms and non-specific imaging findings. We retrospectively reviewed patients with pediatric ovarian masses manifesting torsion.MethodsFifty-eight ovarian masses (55 episodes) in 49 non-neonatal patients treated from April 1984 to March 2017 were retrospectively analyzed. The Mann-Whitney U test and Fisher’s exact test were used for the statistical analysis.ResultsThe median age of these 55 episodes was 10.5 years old (range 1.0–23.0). Thirty-three patients presented with abdominal pain. Forty-five tumors and 13 cystic masses were resected and diagnosed pathologically (50 benign and 8 malignant). Torsion was identified in 15 cases (25.9%) at operation. The torsion masses were all benign, and 8 ovaries (53.3%) were successfully preserved. Comparing the torsion cases with the non-torsion cases, only the white cell count was significantly higher in the torsion cases (p=0.0133) and in the patients presented with abdominal pain (p=0.0068). The duration of abdominal pain was significantly shorter in ovary preserved cases than in oophorectomy cases.ConclusionThe white blood cell may be a helpful indicator of the presence of torsion as well as the need for surgery.

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“…3 Age-specific normal values for ovarian size are not well established, and the suspected ovary should always be compared to the unaffected side. 2 Given the non-specific nature of torsion symptoms, a significant diagnostic delay exists. A recent review reported a median delay of 101 h from first physical examination to surgery, 4 and a study from a single institution reported an average delay for pre-menarchal patients of over 16 h from presentation to surgery.…”

Section: Referencesmentioning

confidence: 99%

Ovarian torsion identified on point‐of‐care ultrasound in the paediatric emergency department

Scheier

Balla

2019

Emerg Medicine Australasia

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Pediatric ovarian torsion: a pictorial review

Cited by 54 publications

References 35 publications

Adnexal Torsion in Children and Adolescents: A Retrospective Review of 245 Cases at a Single Institution

Adnexal Torsion in Children and Adolescents: A Retrospective Review of 245 Cases at a Single Institution

Analysis of the risk of ovarian torsion in 49 consecutive pediatric patients treated at a single institution

Ovarian torsion identified on point‐of‐care ultrasound in the paediatric emergency department

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