Management of adnexal torsion: A 5-year experience from a tertiary center

We aimed to examine the clinical characteristics, surgical findings, histopathological results, laboratory parameters of histopathologically confirmed ovarian torsion cases.

This was a retrospective study that analyzed 96 surgically proven cases of ovarian torsion treated at a tertiary care referral hospital between 2018 and 2024. The study reviewed demographic characteristics, clinical features, surgical details, laboratory findings, and histopathological results of patients through the hospital's electronic medical records. In addition, a comparative analysis was conducted to evaluate differences between patients undergoing laparoscopic and laparotomy surgical approaches.

Ninety-six surgically confirmed ovarian torsions with a median age 27 years were included. The main presenting symptoms were pelvic pain (93.8%) and abdominal pain (40.6%). Laparoscopy was performed in 61 (63.5%) patients, while laparotomy was performed in 35 (36.5%) patients. Surgical approaches included salpingo-oophorectomy with cystectomy (12.1%), salpingo-oophorectomy alone (40.6%), adnexectomy (41.7%), and hysterectomy with bilateral salpingo-oophorectomy (5.2%). Ovarian size ranged from 2-30 cm (mean 7.0 cm) with right-sided involvement in 60.4%. Hemorrhagic infarction was the most common histopathologic finding, followed by simple cysts, with only one case of borderline serous cystadenoma.

Adnexal torsion is a rare emergency requiring a high index of clinical suspicion due to nonspecific symptoms. Surgical intervention is the definitive approach, with laparoscopy preferred for faster recovery and superior outcomes.