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Pediatric Ovarian Torsion.

Krista J Childress1, Jennifer E Dietrich2

  • 1Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main Street, 10th Floor, Houston, TX 77030, USA.

The Surgical Clinics of North America
|November 30, 2016
PubMed
Summary

Adnexal torsion, a gynecologic emergency, presents diagnostic challenges. Prompt laparoscopic detorsion and ovarian preservation are recommended, even for necrotic-appearing ovaries, due to demonstrated ovarian function recovery.

Keywords:
Adnexal torsionAdolescentOvarian torsionPediatricSurgical management

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Area of Science:

  • Gynecology
  • Emergency Medicine
  • Reproductive Endocrinology

Background:

  • Adnexal torsion is a significant gynecologic emergency, ranking fifth in incidence.
  • Diagnosis is often challenging due to vague symptoms and variable imaging findings.
  • Delayed diagnosis can lead to ovarian damage and loss.

Purpose of the Study:

  • To emphasize the importance of prompt intervention in suspected adnexal torsion.
  • To advocate for conservative management including laparoscopic adnexal detorsion and ovarian preservation.
  • To highlight the potential for ovarian function recovery even in cases of apparent ovarian necrosis.

Main Methods:

  • Review of clinical presentation and diagnostic imaging in adnexal torsion cases.
  • Analysis of outcomes following laparoscopic adnexal detorsion and ovarian preservation.
  • Evaluation of ovarian function and patient morbidity after conservative management.

Main Results:

  • Studies consistently demonstrate follicular development and ovarian function post-detorsion.
  • Conservative management with ovarian preservation shows no increased patient morbidity.
  • Prompt surgical intervention is crucial for preserving ovarian viability.

Conclusions:

  • Laparoscopic adnexal detorsion and ovarian preservation should be the standard of care for suspected adnexal torsion.
  • Ovarian viability and function can be restored even when the ovary appears necrotic.
  • Early surgical intervention improves outcomes and reduces the risk of ovarian loss.