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Conservative therapy for adnexal torsion. A case report
1Department of Obstetrics and Gynecology, University of Florida, Gainesville.
The Journal of Reproductive Medicine
|August 1, 1990
Summary
Untwisting the ovarian pedicle during adnexal torsion surgery does not appear to cause thrombotic emboli. Literature review suggests conserving the adnexa is preferable to removal, unless necrotic.
Area of Science:
- Gynecology
- Surgical Oncology
Background:
- Adnexal torsion is commonly treated with oophorectomy due to concerns about thrombotic emboli formation.
- This approach leads to surgical castration, even in cases where ovarian conservation might be possible.
Observation:
- A patient presented with bilateral adnexal torsion caused by dermoid cysts.
- Standard treatment involved oophorectomy, resulting in the patient's surgical castration.
Findings:
- A comprehensive literature review found no reported cases of thrombotic emboli resulting from untwisting the ovarian pedicle.
- Evidence supports conservative management of adnexal torsion, prioritizing adnexal preservation over routine removal.
Implications:
- This challenges the traditional surgical approach for adnexal torsion.
- Adnexal conservation should be considered, reserving oophorectomy for cases with necrotic ovarian tissue.