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Adnexal torsion in children.
N Spigland1, J C Ducharme, S Yazbeck
1Department of Surgery, Hôpital Ste-Justine, University of Montreal, Quebec, Canada.
Journal of Pediatric Surgery
|October 1, 1989
Summary
Pediatric adnexal torsion is rare, often affecting the right side. Delayed diagnosis is common, highlighting the need for pelvic ultrasound in girls with lower abdominal pain.
Area of Science:
- Pediatric Surgery
- Gynecology
- Diagnostic Imaging
Background:
- Adnexal torsion is an uncommon gynecologic emergency in children.
- Previous studies often consist of small case series.
Purpose of the Study:
- To review a consecutive series of pediatric adnexal torsion cases.
- To analyze diagnostic accuracy and outcomes.
Main Methods:
- Retrospective review of 19 pediatric patients (ages 3-19) treated between 1977-1988.
- Analysis of clinical presentation, diagnostic methods, surgical intervention, and outcomes.
Main Results:
- Right adnexal involvement in 84% of cases.
- Delayed diagnosis (average 5.2 days from symptom onset to admission).
- Preoperative diagnostic accuracy was 37%, with appendicitis being a common misdiagnosis.
Conclusions:
- Adnexal torsion in children often presents with delayed diagnosis and poor outcomes.
- Pelvic ultrasound is recommended for female patients with left lower quadrant pain to avoid missed diagnoses.