Case series of paediatric adnexal torsion: rare yet urgent entity
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20164685Keywords:
Conservative surgery, Ovarian torsion, Paediatric age group, Salpingo-oophorectomyAbstract
Ovarian torsion is a true emergency which warrants early diagnosis and timely surgical management to avoid the catastrophic consequences of further adnexal injury. In paediatric population, this is especially dangerous as the condition can go undiagnosed because of its rarity and nonspecific presentation of disease. This leads to delay in surgical exploration and loss of ovarian function. We encountered 6 cases of ovarian torsion in paediatric age group during a period of 2 years, at a tertiary care hospital in Ahmedabad. After enquiry of the symptoms and a series of investigations, a provisional diagnosis of torsion ovary was made and they were taken up for surgery. Intra-operatively all the patients were found to have non-salvageable ovary and fallopian tube on the affected side, and subsequently they underwent salpingo-oophorectomy. Diagnosis of ovarian torsion requires clinician awareness and a high degree of suspicion. Conservative surgery, in the form of ovarian detorsion can be tried in cases of ischemia but if ovarian necrosis has occurred, then salpingo-oophorectomy is performed as the last resort.
Metrics
References
Hibbard LT. Adnexal torsion. Am J Obstet Gynecol. 1985;152:456-61.
Bridgette DG, Mark DA, Elizabeth CP. Incidence and Trends of Pediatric Ovarian Torsion Hospitalizations in the United States, 2000- 2006. Pediatrics. 2010;125:532.
Hannah CC, Shweta B, Vikram SD. Pearls and Pitfalls in Diagnosis of Ovarian Torsion. RadioGraphics. 2008;28:1355-68.
Jennifer Eng-Lunt, Heather A, Jahn A. Pediatric and Adolescent Ovarian Torsion. ACEP News. 2011.
Poonai N, Poonai C, Lim R, Lynch T. Pediatric ovarian torsion: case series and review of the literature. Canadian Journal of Surgery. 2013;56(2):103-8.
Anders JF, Powell EC. Urgency of Evaluation and Outcome of Acute Ovarian Torsion in Pediatric Patients. Arch Pediatr Adolesc Med. 2005;159(6):532-5.
Lo LM, Chang SD, Horng SG, Yang TY, Lee CL, Liang CC. Laparoscopy versus laparotomy for surgical intervention of ovarian torsion. J Obstet Gynaecol Res. 2008;34(6):1020-5.
Tsafrir Z, Azem F, Hasson J, Solomon E, Almog B, Nagar H. Risk factors, symptoms and treatment of ovarian torsion in children: the twelve-year experience of one centre. J Minim Invasive Gynecol. 2012;19(1):29-33.
Ashwal E, Krissi H, Hiersch L, Less S, Eitan R, Peled Y. Presentation, Diagnosis and Treatment of Ovarian Torsion in Premenarchal Girls. J Pediatr Adolesc Gynecol. 2015;28(6):526-9.
Oskayli MC, Durakbasa, Masrabaci, Mutus, Zemheri IE, Okur H. Surgical Approach to Ovarian Torsion in Children. J Pediatr Adolesc Gynecol. 2015;28(5):343-7.
Smail A. Acute ovarian torsion in young girls. Journal of Acute Disease. 2016;1:59-61.
Kokoska ER, Keller MS, Weber TR. Acute ovarian torsion in children. Am J Surg. 2000;180:462-5.
Shauna D, Esther O, Susanna IL. Ovarian Torsion: Diagnostic features on CT and MRI with Pathologic Correlation. American Journal of Roentgenology. 2012;198(2):122-31.
Oltmann SC, Fischer A, Barber R, Huang R, Hicks B, Garcia N. Cannot exclude torsion – a 15-year review. J Pediatr Surg. 2009;44(6):1212-6.
Ganer HH, Shalev A, Ginat S, Kerner R, Keidar R, Bar J. Clinical characteristics of adnexal torsion in premenarchal patients. Arch Gynecol Obstet. 2016;293(3):603-8.
Bellet GC, Gehri M, Joseph JM, Pauchard JY. Is it Ovarian Torsion? A Systematic Literature Review and Evaluation of Prediction Signs. Pediatr Emerg Care. 2016;32(4):256-61.
Krissi H, Hiersch L, Aviram A, Ashwal E, Goldschmit, Peled Y. Factors Affecting Adnexal Torsion Direction: A Retrospective Cohort Study. Obstet Gynecol. 2016;81:405-10.
Jennifer FA, Elizabeth CP. Urgency of Evaluation and Outcome of Acute Ovarian Torsion in Pediatric Patients. Arch Pediatr Adolesc Med. 2005;159(6):532-5.
Claudio S, Irene B, Valentina P, Josephine L, Elisabetta A, Luca N. Adnexal torsion in children and adolescents: new trends to conservative surgical approach – Our experience and review of literature. Gynecological Endocrinology. 2013;29:1.
