DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150123

Laparoscopic detorsion of gangrenous adnexae followed by interval cystectomy: case report and review of the literature

Roziana Ramli, Halimatun Mansor, Yusmadi Abdullah, Noraini Mulalek, Wan Abu Bakar Yusoff

Abstract


A 15 year old girl presented with a 1-day history of acute abdomen. Abdominal ultrasound revealed a left adnexal cyst measuring 8x7 cm. Laparoscopic examination demonstrated an 8 cm left gangrenous adnexal torsion. After detorsion of the left adnexae, the left fallopian tube appeared to be viable however the left ovary remained the same. Postoperative period was uneventful and serial ultrasound showed persistence of the cyst. The left ovary appeared to be completely viable through a repeat laparoscopic examination 6 weeks later and interval left cystectomy was performed. A twisted gangrenous adnexae could be managed by adnexal sparing surgery successfully.


Keywords


Twisted gangrenous adnexae, Detorsion, Adnexal sparing surgery

Full Text:

PDF

References


Skinner MA, Schlatter MG, Heifetz SA, Grosfeld JL. Ovarian neoplasms in children. Arch Surg. 1993;128:849-53.

Oelsner G, Cohen SB, Soriano D, Admon D, Mashiach S, Carp H. Minimal surgery for the twisted schaemic adnexa can preserve ovarian function. Hum Reprod. 2003;18:2599-602.

Kirkham YA, Lacy JA, Kives S, Allen L. Characteristics and management of adnexal masses in a Canadian pediatric and adolescent population J Obstet Gynaecol Can. 2011 Sep;33(9):935-43.

Ahmet Çelik, Orkan Ergün, Hakan Aldemir, Coşkun Özcan, Geylani Özok, Ata Erdener, et al. Long-term results of conservative management of adnexal torsion in children. J Pediatr Surg. 2005 Apr;40(4):704-8.

Breech L, Hillard P. Adnexal torsion in pediatric and adolescent girls. Curr Opin Obstet Gynecol. 2005;17:483-9.

Broach AN, Mansuria SM, Sanfilippo JS. Pediatric and adolescent gynecologic laparoscopy. Clin Obstet Gynecol. 2009;52:380-9.

Aziz D, Davis V, Allen L, Langer JC. Ovarian torsion in children: is oophorectomy necessary? J Pediatr Surg. 2004;39:750-3.

Oltmann SC, Fischer A, Barber R, Huang R, Hicks B, Garcia ZL, et al. Adnexal torsion in pediatric and adolescent girls. Curr Opin Obstet Gynecol. 2005;17:483-9.

Yiu-Tai Li, Lung-ChingKuon, Po-Ning Lee, Tsung-Cheng Kuo. Laparoscopic detorsion of twisted ovary. J Chinese Med Assoc. 2005 Dec;68(12):595-8.

Anders J. Ovarian torsion in the pediatric emergency department: making the diagnosis and the importance of advocacy. Clin Ped Emerg Med. 2009;10:31-7.

Parelkar SV, Mundada D, Sanghvi BV, Joshi PB, Oak SN, Kapadnis SP, et al. Should the ovary always be conserved in torsion? A tertiary care institute experience. J Pediatr Surg. 2014;49:465-8.

McGovern PG, Noah R, Koenigsberg R, Little AB. Adnexal torsion and pulmonary embolism: case-report and review of the literature. Obstet Gynecol Surv. 1999;54(9):601-8.

Wagaman R, Williams RS. Conservative therapy for adnexal torsion: case report. J Reprod Med. 1990;35:833-4.

Cass DL. Ovarian torsion. Semin Pediatr Surg. 2005;14(2):86.

Sommerville M, Grimes DA, Koonings PP, Campbell K. Ovarian neoplasms and the risk of adnexal torsion. Am J Obstet Gynecol. 1991;164:577-8.

Rody A, Jackish C, Klockenbusch W, Heinig J, Coenen-Worch V, Schneider HP. The conservative management of adnexal torsion - a case-report and review of the literature. Eur J Obstet Gynecol Reprod Biol. 2002;101:83-6.

Bider D, Mashiach S, Dulitzky M, Kokia E, Lipitz S, Ben-Rafael Z. Clinical, surgical and pathologic findings of adnexal torsion in pregnant and nonpregnant women. Surg Gynecol Obstet. 1991;173:363-6.

Shalev J, Goldenberg M, Oelsner G, Ben-Rafael Z, Bider D, Blankstein J, et al. Treatment of twisted ischaemic adnexae by simple detorsion. N Engl Med. 1989;24:546.

Geimanaite L, Trainavicius K. Ovarian torsion in children: Management and outcomes. J Pediatr Surg. 2013;48:1946-53.

Rousseau V, Massicot R, Darwish AA, Sauvat F, Emond S, Thibaud E, et al. Emergency management and conservative surgery of ovarian torsion in children: a report of 40 cases. J Pediatr Adolesc Gynecol. 2008;21:201-6.

Styer AK, Laufer MR. Ovarian bivalving after detorsion. Fertil Steril. 2002;77:1053-5.

Galinier P, Carfagna L, Delsol M, Ballouhey Q, Lemasson F, Le Mandat A, et al. Ovarian torsion. Management and ovarian prognosis: a report of 45 cases. J Pediatr Surg. 2009;44:1759-65.