F Meynol1, H Steyaert, J S Valla. 1. Service de chirurgie pédiatrique, Fondation Lenval pour Enfants, Nice, France.
Abstract
BACKGROUND: Experience with adnexa torsion in children, a rare but potentially severe pathology, is still disappointing despite constant radiological progress. PATIENTS AND METHODS: The files of 19 patients with adnexial torsion treated between 1985 and 1995 were retrospectively reviewed and compared to those reported. RESULTS: Eight adnexectomies, six oophorectomies, five detorsions with cystectomy and one salpingectomy were performed. There were only five salvaged adnexa in this series. Three tumors were found; all other cases, except three, were torsions induced by voluminous functional cysts. DISCUSSION AND CONCLUSION: Clinical context (sudden right pelvic pain without fever) seems important to note. Sonographic examination is first necessary, but its results are not accurate enough to confirm the torsion. Endo-rectal ultrasonography should become the best diagnostic method in cases of complicated ovaries. In order to increase the percentage of salvaged adnexa, the authors recommend a laparoscopic approach in emergency when clinical examination was doubtful.
BACKGROUND: Experience with adnexa torsion in children, a rare but potentially severe pathology, is still disappointing despite constant radiological progress. PATIENTS AND METHODS: The files of 19 patients with adnexial torsion treated between 1985 and 1995 were retrospectively reviewed and compared to those reported. RESULTS: Eight adnexectomies, six oophorectomies, five detorsions with cystectomy and one salpingectomy were performed. There were only five salvaged adnexa in this series. Three tumors were found; all other cases, except three, were torsions induced by voluminous functional cysts. DISCUSSION AND CONCLUSION: Clinical context (sudden right pelvic pain without fever) seems important to note. Sonographic examination is first necessary, but its results are not accurate enough to confirm the torsion. Endo-rectal ultrasonography should become the best diagnostic method in cases of complicated ovaries. In order to increase the percentage of salvaged adnexa, the authors recommend a laparoscopic approach in emergency when clinical examination was doubtful.