The Value of Laparoscopy in Acute Pelvic Pain

Anteby, Shaoul O.; Schenker, Joseph G.; Polishuk, W.Z.

doi:10.1097/00000658-197504000-00022

Cited by 79 publications

(28 citation statements)

References 4 publications

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“…Ovarian torsion has been found to represent between 2.5-7.4% of all cases of acute abdomen (Anteby et al 1975;Hibbard 1985). Thus, it is not uncommon for the diagnosis to be made only after emergent diagnostic laparoscopy (Mage et al 1989;Porpora and Gomel 1997).…”

Section: Discussionmentioning

confidence: 99%

Predictive Factors for Ovarian Necrosis in Torsion of Ovarian Tumor

Tobiume

Shiota

Umemoto

et al. 2011

Tohoku J. Exp. Med.

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Most cases of ovarian torsion require emergency surgery; the ovary has become necrotic and cannot be conserved. Preoperative determination of the ovarian necrosis extent is difficult but it may increase the likelihood of the ovary conservation. In this study, we retrospectively evaluated the findings in ovarian torsion among patients with ovarian tumors who underwent emergency surgery at a single hospital for possible preoperative indicators of ovarian viability. We thus evaluated 77 patients who were intraoperatively diagnosed with torsion of ovarian tumor between 1995 and 2010. These patients were classified into three groups depending on the postoperative histopathological findings: necrotic, congestive, and normal. Preoperative C-reactive protein (CRP) level, leukocyte count, and body temperature, along with tumor size, degree of torsion, time from the onset of abdominal pain to surgery, and incidence of acute abdomen were compared among the three groups. The sensitivity, specificity, and positive and negative predictive values of the preoperative serum CRP levels for ovarian necrosis were calculated. The CRP level, degree of torsion, and time from the onset of abdominal pain to surgery were significantly higher in the necrotic group than in the normal group. The sensitivity and specificity of the CRP level for necrosis were 35% and 83%, respectively, and positive and negative predictive values were 38% and 82% respectively. The potential for ovary conservation in suspected ovarian torsion should be greater if the tumor is non-malignant, the time from the onset of abdominal pain to operation is short, and the CRP level is < 0.3 mg/dl.

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Section: Discussionmentioning

confidence: 99%

Predictive Factors for Ovarian Necrosis in Torsion of Ovarian Tumor

Tobiume

Shiota

Umemoto

et al. 2011

Tohoku J. Exp. Med.

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“…Ovarian torsion has been found to represent between 2.5% and 7.4% of surgical cases of acute abdomen [7,8]. Thus, it is not uncommon for the diagnosis to be made only after emergency diagnostic laparoscopy [9,10].…”

Section: Discussionmentioning

confidence: 99%

Clinical indices and histological changes over time in ovarian torsion related to ovarian tumors

et al. 2011

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In some emergency surgeries for ovarian torsion, the ovary cannot be conserved because of necrosis. Ovarian necrosis and the time from the onset of symptoms to surgery are likely to be directly correlated. In this study, we retrospectively evaluated the clinical indices from the time of onset of acute abdomen to surgery at our hospital, in patients with tumor-related ovarian torsion. Among cases diagnosed preoperatively with benign ovarian tumors between 1995 and 2010, there were 54 patients who developed acute abdomen that was surgically diagnosed as ovarian torsion. For evaluation, these patients were divided into two groups according to the time from the onset of acute abdomen to surgical intervention as follows: <10 and ≥10 h. C-reactive protein (CRP) levels, leukocyte counts, body temperature, tumor size, and degree of torsion were compared between the two patient groups. Ovarian status based on postoperative histopathology was classified as necrotic, congestive, or normal, and was also evaluated. The mean CRP level was significantly higher in the ≥10-h patient group than in the patients undergoing surgery in <10 h. No differences were observed between the two groups for leukocyte counts, body temperature, tumor size, and mean degree of torsion. Ovarian necrosis was only observed only in patients undergoing surgery at ≥10 h. When tumorrelated ovarian torsion is suspected, surgery should be performed within 10 h after the onset of acute abdomen to conserve ovarian function.

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“…In young women especially, a high incidence of negative appendectomies has been reported [9,15,18]. In patients with acute pelvic pain that cannot be clearly related to acute appendicitis, we prefer diagnostic laparoscopy over the open approach because it provides a more accurate diagnosis and reduces the error rate in the diagnosis of acute appendicitis [1,3,9,12,19,20,22]. Additionally, diagnostic laparoscopy may be combined with laparoscopic appendectomy or other laparoscopic surgical procedures whenever necessary.…”

Section: Discussionmentioning

confidence: 99%