Acute pain abdomen in adolescents: a gynecologist’s dilemma
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232728Keywords:
Ovarian cyst, Ovarian torsion, Ovarian tumorAbstract
Background: Ovarian torsion is 5th most common emergency in gynecology. Benign functional ovarian cysts and benign teratomas are most common among ovarian torsion. Aims and objectives were to study the outcome and HPE of all adolescent girls presenting with acute pain abdomen at BGS GIMS, Bangalore.
Methods: A study was conducted at BGS GIMS from 2020 to 2022 of all children and adolescents presenting with acute pain abdomen. Study included data consisting of age, complaints, investigations, intervention and HPE was collected and analysed.
Results: There were 21 cases between 12- and 21-years age group who presented with acute pain abdomen in the study period. Majority of them were of 16-19 years age group. Out of 21 cases, 100% of them presented with acute pain abdomen. Operative procedures included 15 (71%) exploratory laparotomy and 6 (29%) operative laparoscopies. Ovarian torsion was seen in 11 cases of which 2 cases had bilateral ovarian torsion and 9 cases had unilateral torsion. Ovarian cystectomy was done in 7 patients, unilateral oophorectomy in 3 patients and unilateral salpingo-oophorectomy in 6 patients. Histopathology reports showed 5 cases of serous cystadenoma, 1 case of teratoma and others were mostly simple cyst or corpus luteal cysts.
Conclusions: Acute pain abdomen in adoloscents should be diagnosed early to prevent from risk of ovarian torsions. Operative procedures should aim at fertility preservation.
References
AlDakhil L, Aljuhaimi A, AlKhattabi M, Alobaid S, Mattar RE, Alobaid A. Ovarian neoplasia in adolescence: a retrospective chart review of girls with neoplastic ovarian tumors in Saudi Arabia. J Ovarian Res. 2022;15(1):1-7.
Patel AS, Patel JM, Shah KJ. Ovarian tumors-Incidence and histopathological spectrum in tertiary care center, Valsad. IAIM. 2018;5(2):84-93.
Cohen SB, Oelsner G, Seidman DS, Admon D, Mashiach S, Goldenberg M. Laparoscopic detorsion allows sparing of the twisted ischemic adnexa. J Am Assoc Gynecol Laparosc. 1999;6(2):139-43.
Tanksale S, Bendre K, Niyogi G. Adolescent ovarian tumours: a gynecologist’s dilemma. Int J Reprod Contracept Obstet Gynecol. 2015;4:833-6.
Akyüz C, Varan A, Büyükpamukçu N, Kutluk T, Büyükpamukçu M. Malignant ovarian tumors in children: 22 years of experience at a single institution. J Pediatr Hematol Oncol. 2000;22(5):422-7.
Gupta A, Gadipudi A, Nayak D. A five-year review of ovarian torsion cases: lessons learnt. J Obstet Gynaecol India. 2020;70(3):220-4.
Andrés MM, Costa E, Canete A, Moreno L, Castel V. Solid ovarian tumours in childhood: a 35-year review in a single institution. Clin Transl Oncol. 2010;12(4):287-91.
Kirkham YA, Kives S. Ovarian cysts in adolescents: medical and surgical management. Adolesc Med State Art Rev. 2012;23(1):178-91.
Jha R, Karki S. Histological pattern of ovarian tumors and their age distribution. Nepal Med Coll J. 2008;10(2):81-5.
Kar T, Mohapatra APC. Intraoperative cytology of ovarian tumours. J Obstet Gynecol India. 2005;55(4):345-9.
