Julia Tasset1, Monica Woll Rosen2, Sara Bell3, Yolanda Regina Smith3, Elisabeth H Quint3. 1. Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan; Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania. 2. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan. Electronic address: mwoll@med.umich.edu. 3. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
Abstract
STUDY OBJECTIVE: To investigate characteristics that differentiate premenarchal girls with ovarian torsion (OT) from those without OT at the time of surgery. DESIGN: Retrospective chart review of 36 premenarchal girls who underwent 42 surgeries for either OT (n = 33) or a nontorsed ovarian mass (n = 9) from 2006 to 2017. SETTING: Large, tertiary care academic institution. PARTICIPANTS: We included patients aged 0-12 years with International Classification of Diseases, Ninth Revision codes for torsion of the ovary, adnexa, ovarian pedicle, or fallopian tube. Controls had International Classification of Diseases, Ninth Revision codes for ovarian mass or cyst, who also underwent surgery and did not have OT. INTERVENTIONS: Records were reviewed for patient characteristics including laboratory and imaging studies, surgical intervention, and pathologic diagnosis. Fischer exact test and the nonparametric Mann-Whitney U test were used for statistical analysis. MAIN OUTCOME MEASURES: Characteristics predictive of OT in premenarchal girls. RESULTS: Twenty-nine premenarchal patients were diagnosed with 33 episodes of OT. Nine patients underwent surgery for ovarian masses but did not have OT. All patients with OT reported abdominal pain (compared with 55.6% without OT; P < .001) and most had nausea and/or emesis (81.8% vs 33.3%; P < .009). Ultrasound findings of ovarian enlargement and decreased Doppler flow were significant in the OT group (P < .083, P < .009). There were 2 cases of malignancy in each group. CONCLUSION: Patients with OT had significantly more nausea, emesis, and abdominal pain compared with those without OT. Additionally, 2 of 4 malignancies were found in patients with OT, indicating that malignancy should still be considered with large, complex masses.
STUDY OBJECTIVE: To investigate characteristics that differentiate premenarchal girls with ovarian torsion (OT) from those without OT at the time of surgery. DESIGN: Retrospective chart review of 36 premenarchal girls who underwent 42 surgeries for either OT (n = 33) or a nontorsed ovarian mass (n = 9) from 2006 to 2017. SETTING: Large, tertiary care academic institution. PARTICIPANTS: We included patients aged 0-12 years with International Classification of Diseases, Ninth Revision codes for torsion of the ovary, adnexa, ovarian pedicle, or fallopian tube. Controls had International Classification of Diseases, Ninth Revision codes for ovarian mass or cyst, who also underwent surgery and did not have OT. INTERVENTIONS: Records were reviewed for patient characteristics including laboratory and imaging studies, surgical intervention, and pathologic diagnosis. Fischer exact test and the nonparametric Mann-Whitney U test were used for statistical analysis. MAIN OUTCOME MEASURES: Characteristics predictive of OT in premenarchal girls. RESULTS: Twenty-nine premenarchal patients were diagnosed with 33 episodes of OT. Nine patients underwent surgery for ovarian masses but did not have OT. All patients with OT reported abdominal pain (compared with 55.6% without OT; P < .001) and most had nausea and/or emesis (81.8% vs 33.3%; P < .009). Ultrasound findings of ovarian enlargement and decreased Doppler flow were significant in the OT group (P < .083, P < .009). There were 2 cases of malignancy in each group. CONCLUSION:Patients with OT had significantly more nausea, emesis, and abdominal pain compared with those without OT. Additionally, 2 of 4 malignancies were found in patients with OT, indicating that malignancy should still be considered with large, complex masses.
Authors: Emily C Alberto; Jun Tashiro; Yinan Zheng; Anthony Sandler; Timothy Kane; Veronica Gomez-Lobo; Mikael Petrosyan Journal: Pediatr Surg Int Date: 2020-11-26 Impact factor: 1.827