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Ovarian torsion in children: management and outcomes
Lina Geimanaite1, Kestutis Trainavicius
1Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Department of Pediatric Surgery, Children's Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
Insights
Conservative surgical treatment for ovarian torsion in children is safe and effective. Detorsion and leaving ovaries in the abdominal cavity preserved normal anatomy and function, with no reported complications.
Area of Science:
- Pediatric Surgery
- Gynecology
- Reproductive Health
Background:
- Ovarian torsion is a gynecological emergency in children.
- Understanding clinical presentation, diagnosis, and management is crucial.
Purpose of the Study:
- To evaluate clinical symptoms, diagnosis, management, and outcomes of ovarian torsion in pediatric patients.
- To assess the long-term efficacy and safety of conservative surgical management.
Main Methods:
- Retrospective review of 53 cases of ovarian torsion in children (1989-2012).
- Analysis of long-term outcomes for 20 girls who underwent ovarian detorsion and preservation.
- Clinical and ultrasound follow-up was utilized.
Main Results:
- Ovaries were removed in 22 cases and preserved in 31 cases.
- Preserved ovaries, though initially discolored (black-bluish or bluish), maintained function.
- Since 2005, all treated ovaries were preserved; long-term follow-up showed multifollicular ovaries in 17 girls, with normal or microfollicular development in others.
Conclusions:
- Conservative surgical treatment (detorsion and ovarian preservation) is safe and effective for pediatric ovarian torsion.
- Preserved ovaries maintained normal anatomy and function long-term.
- No thromboembolism, peritonitis, or malignant tumors were observed post-conservative surgery.
Background:
The purpose of this study is to evaluate the clinical symptoms, diagnosis, management, and outcomes in children with ovarian torsion.
Methods:
The charts of 50 patients with 53 cases of ovarian torsion treated between January 1989 and March 2012 were reviewed retrospectively. Long term follow up was available for 20 girls who had their ovaries left in the abdominal cavity after detorsion.
Results:
In 22 cases ovaries were removed, and in 31 cases the torsion was relieved and the ovaries left in the abdominal cavity. Twenty-five of the salvaged ovaries were black-bluish and 10 bluish in color. Since 2005, after a change in preferred treatment, all ovaries treated by detorsion were left in the abdominal cavity. The long term results were observed clinically and by ultrasound in 20 girls. Multifollicular ovaries were found in 17 girls. One girl had a normal size paucifollicular ovary, a one-year-old girl had a normal size ovary with microfollicles, and one girl had no ovarian material detectable by ultrasound.
Conclusions:
Long term analysis of the treatment of ovarian torsion revealed that ovaries treated by detorsion and left in the abdominal cavity preserved their normal anatomy and function. Conservative surgical treatment proved to be safe. None of the girls had thromboembolism or peritonitis, and no malignant tumors were found in the operated ovaries.
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