DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20161276

Adnexal torsion-symptoms, diagnosis and management: a review of literature

Nidhi Jain, Rahul Manchanda, Sravani Chithra, Anshika Lekhi

Abstract


Adnexal torsion accounts for 3% of all gynaecologic emergencies. It consists of spectrum of pathologies including ovarian torsion, ovarian torsion with tubal torsion and isolated fallopian tube torsion. It usually presents with acute abdominal pain along with gastrointestinal symptoms such as nausea and vomiting. But due to presence of non-specific clinical features, diagnosis of adnexal torsion is a difficult task which requires high degree of clinical suspicion. Ultrasound with Doppler is helpful in its diagnosis. But even Doppler studies can miss the cases of adnexal torsion. So, laparoscopy is the gold standard for its diagnostic evaluation and simultaneous management. Conservative surgery should be preferred to preserve the future reproductive function. But in some cases such as infarcted ovaries, older women and suspicion of malignancy, adnexa may be required to be removed. Thus, prompt diagnosis and timely management of adnexal torsion is required to prevent the irreversible damage to adnexa. The authors here present a review of literature concerning the clinical features, diagnosis and management of adnexal torsion via a case series of six cases.

Keywords


Adnexal torsion, Isolated fallopian tube torsion, Ovarian torsion

Full Text:

PDF

References


Kontoravdis A, Chryssikopoulos A, Hassiakos D, Liapis A, Zourlas PA. The diagnostic value of laparoscopy in 2365 patients with acute and chronic pelvic pain. Int J Gynaecol Obstet. 1996;52:243-8.

Ahn JH, Chung J, Lee TS. Successful laparoscopic surgery for14-month-old infant with ovarian torsion. Obstet Gynecol Sci. 2014;57(2):160-3.

Gaied F, Emil S, Lo A, Baird R, Laberge JM. Laparoscopic treatment of isolated salpingeal torsion in children: case series and a 20-year review of the literature. J Laparoendosc Adv Surg Tech A. 2012;22:941-7.

Bland-Sutton T. Salpingitis and some of its effects. Lancet. 1890;2:1146.

Casey RK, Damle LF, Gomez-Lobo V. Isolated fallopian tube torsion in pediatric and adolescent females: a retrospective review of 15 cases at a single institution. J Pediatr Adolesc Gynecol. 2013;26(3):189-92.

Djing DC, Hsu S, Kao SP. Isolated torsion of hydrosaplinx in a postmenopusal woman. JSLS. 2007;11(2):252-4.

Kardakis S, Barranca A, Vitelli A, Amore I, Trento F, Caccia G. Isolated Fallopian Tube Torsion. Case Rep Obstet Gynecol. 2013;2013:479698.

Wong SW, Suen SH, Lao T, Chung KH. Isolated fallopian tube torsion: a series of six cases. Acta Obstet Gynecol Scand. 2010;89(10):1354-6.

Lima M, Libri M, Aquino A, Gobbi D. Bilateral hydrosaplinx with asynchronous tubal torsion: an exceptional finding in a premenarcheal girl. J Pediatr Surg. 2011;46:e27-9.

Phillips K, Fino ME, Kump L, Berkeley A. Chronic isolated fallopian tube torsion. Fertil Steril. 2009;92:394.e1-3.

Erikci VS, Hosgor M. Isolated salpingeal torsion in children: a case series and review of the literature. Ulus Travma Acil Cerr Derg. 2014;20(1):75-8.

Vijaya Raghavan SB, Senthil S. Isolated torsion of the fallopian tube: the sonographic whirlpool sign. J Ultrasound Med. 2009;28(5):657-62.

Sun LT, Ning CP, Guo XJ, Li XY, Liu W, Tian JW. Role of ultrasound in diagnosing isolated torsion of fallopian tube. J Obstet Gynaecol Res. 2014;40(1):208-14.

Bernardus RE, Van der Slikke JW, Roex AJ, Dijkhuizen GH, Stolk JG. Torsion of the fallopian tube: some considerations on its etiology. Obstet Gynecol. 1984;64:675-8.

Harmon JC, Binkovitz LA, Binkovitz LE. Isolated fallopian tube torsion: sonographic and CT features. Pediatr Radiol. 2008;38:175-9.

Cohen S, Wattiez A, Seidman D, Goldenberg M, Admon D, Mashiach S et al. Laparoscopy versus laparotomy for detorsion and sparing of twisted ischemic adnexa. JSLS. 2003;7:295-9.

Boukaidi SA, Delotte J, Steyaert H, Valla JS, Sattonet C, Bouaziz J et al. Thirteen cases of isolated tubal torsions associated with hydrosalpinx in children and adolescents, proposal for conservative management: retrospective review and literature survey. J Pediatr Surg. 2011;46(7):1425-31.

White M, Stella J. Ovarian torsion: 10-year perspective. Emerg Med Australas. 2005;17:231-7.

Sahlu Z, Negash S, Yusuf L. Adnexal torsion a five-years retrospective review in two hospitals. Ethiop Med J. 2014;52(4):155-64.

Ryan MF, Desai BK. Ovarian torsion in a 5-Year old: a case report and review. Case reports in emergency medicine. 2012;2012(5):679121.

Poonai N, Poonai C, Lim R, Lynch T. Pediatric ovarian torsion: case series and review of the literature. Can J Surg. 2013;56(2):103-8.

Peng YY, Chen CP, Chien SC, Chen JR. Torsion of a huge ovarian cyst in a 90-year-old woman. Taiwan J Obstet Gynecol. 2008;47(2):224-5.

Yousefi Z, Farazestanian M, Mottaghi M, Pourmoghadam N. Ovarian torsion in postmenopausal women and risk of malignancy. Journal of midwifery and reproductive health. 2015;3(4):479-82.

Huchon C, Fauconnier A. Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol. 2010;150:8-12.

Melcer Y, Sarig-Meth T, Maymon R, Pansky M, Vaknin Z, Smorgick N. Similar but different: a comparison of adnexal torsion in pediatric, adolescent, and pregnant and reproductive-age women. J Womens Health (Larchmt). 2016;25(4):391-6.

Al-Turki HA. Adnexal torsion in children: the role of family practice physicians and paediatricians. J Taibah Uni Med Sci. 201;11(1):46-9.

Rousseau V, Massicot R, Dwarish 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.

Spinelli C, Buti I, Pucci V, Liserre J, Alberti E, Nencini L. Adnexal torsion in children and adolescents: new trends to conservative surgical approach -our experience and review of literature. J Gynecol Endocrinol. 2013;29(1):54-8.

Shadinger LL, Andreotti RF, Kurian RL. Preoperative sonographic and clinical characteristics as predictors of ovarian torsion. J Ultrasound Med. 2008;27:7-13.

Lee EJ, Kwon HC, Joo HJ, Suh JH, Fleischer AC. Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J Ultrasound Med. 1998;17(2):83-9

Ben-Ami M, Perlitz Y, Haddad S. The effectiveness of spectral and color Doppler in predicting ovarian torsion: a prospective study. Eur J Obstet Gynecol Reprod Biol. 2002;104:64-6.

Albayram F, Hamper UM. Ovarian and adnexal torsion: spectrum of sonographic findings with pathologic correlation. J Ultrasound Med. 2001;20(10):1083-9.

Aziz D, Davis V, Allen L, Langer JC. Ovarian torsion in children: is oophorectomy necessary? J Pediatr Surg. 2004;39(5):750-3.

Tsafrir Z, Foad Azem, Hasson J, Solomon E, Almog B, Nagar H, et al. Risk factors, symptoms, and treatment of ovarian torsion in children: the twelve year experience of one center. J Minimal Invasive Gynaecol. 2012;19:29-33.

Lasso Betancor CE, Garrido Pérez JI, Murcia Pascual FJ, Granero Cendón R, Vargas Cruz V, Paredes Esteban RM. Ovarian torsion: long-term follow-up of the black-bluish ovary after laparoscopic detorsion. Cir Pediatr. 2014;27(1):26-30.