Pediatric Ovarian Torsion and its Recurrence: A Multicenter Study

Bertozzi, Mirko; Esposito, Ciro; Vella, Claudio; Briganti, Vito; Zampieri, Nicola; Codrich, Daniela; Ubertazzi, Michele; Trucchi, Alessandro; Magrini, Elisa; Battaglia, Sonia; Bini, Vittorio; Conighi, Maria Luisa; Gulìa, Caterina; Farina, Alessandra; Camoglio, Francesco Saverio; Rigamonti, Waifro; Gamba, Piergiorgio; Riccipetitoni, Giovanna; Chiarenza, Salvatore Fabio; Inserra, Alessandro; Appignani, Antonino

doi:10.1016/j.jpag.2016.11.008

Cited by 29 publications

(27 citation statements)

References 36 publications

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“…33e35 In our With adnexal pathology, recurrence rates of up to 12% have been reported; it appears to be even higher among premenarchal girls found to have otherwise normal ovaries and fallopian tubes. 13,19,38,40,41 In our cohort, there was a recurrence rate of 3.4% and although no association could be made regarding pubertal status, it was noted that none had pathologic lesions with the initial torsion.…”

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confidence: 59%

“…Nonetheless, experienced surgeons suggest that oophoropexy can be offered in the setting of recurrent torsion, absent contralateral ovary presence, elongated ovarian ligament, and torsion of normal adnexa. 19,40,43 In our cohort, 5 of the 8 recurrences (62.5%) received an oophoropexy during their second presentation, none of which had associated pathology during the initial or subsequent surgery.…”

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confidence: 81%

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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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confidence: 59%

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confidence: 81%

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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“…In doing so, the title of the article would be more congruent and the concept that adnexal torsion is not simply a postmenarchal problem would be strengthened. This is also supported by our recent multicenter study in a pediatric population aged up to 14 years, in which the occurrence of ovarian torsion in the premenarchal period was 67.7% (2).…”

Section: Pediatric Adnexal Torsionsupporting

confidence: 77%

“…We congratulate the authors because their rate of oophorectomy is lower than that observed in our previous retrospective 10-year study (62%), although this result may be susceptible of further improvement (2). This issue was recognized by the authors when they affirm that different approaches to the ischemic-appearing ovaries may affect the rate of adnexal salvage, with teaching hospitals having the highest de-torsion rate without performing oophorectomy (8).…”

Section: Pediatric Adnexal Torsionmentioning

confidence: 77%

Pediatric Adnexal Torsion

Bertozzi

Appignani

2018

The Journal of Emergency Medicine

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“…Half of pediatric patients with ovarian torsion are induced by an ovarian mass, including cystic and solid masses 2–4. Torsion of normal ovary, which can be caused by functional and hemorrhagic cysts, has also been reported 3. In spite of recent progress in diagnostic imaging, an early diagnosis of ovarian torsion is sometimes difficult due to variable clinical symptoms and non-specific imaging findings 3 5.…”

Section: Introductionmentioning

confidence: 99%

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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Pediatric Ovarian Torsion and its Recurrence: A Multicenter Study

Cited by 29 publications

References 36 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

Pediatric Adnexal Torsion

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

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