Clinico-pathological profile of adnexal torsion cases: a retrospective analysis from a tertiary care teaching hospital (original) (raw)
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Management and outcomes of adnexal torsion: a 5-year experience
Archives of Gynecology and Obstetrics, 2010
Purpose To discuss the surgical results of patients with diagnosis of adnexal torsion. Methods One hundred and fifty patients with diagnosis of adnexal torsion who presented to our clinic between January 2005 and December 2009 were included in this retrospective analysis. Data regarding age, gravidity, parity, size of mass, operation time, and duration of hospitalization were recorded and compared between the patients who had laparoscopy to those who had laparotomy. The pathological results of patients were also recorded. Results Fifty-eight patients were treated laparoscopically while 92 patients had laparotomy. The most frequent presenting symptom was pelvic pain (96%). Laparoscopy group consisted of young patients with low parity; operation and hospital stay time was shorter in laparoscopy group. Velocity loss in Doppler ultrasonography was noted in 81.3% of the patients. Of the laparotomy group 35 postmenopausal patients had hysterectomy and bilateral salpingo-oopherectomy, and staging surgery was done for 16 of them. The pathological finding was found to be malignant in four and borderline serous tumor in four patients. Conclusion Laparoscopy is preferred for young patients who want to preserve their fertility. Because of high risk of malignancy in postmenopausal ovarian masses presenting with torsion; frozen section should be used. If not possible or not conclusive, staging surgery is more appropriate especially if there is suspicion of malignancy.
Adnexal torsion: a single-center retrospective study of diagnosis and treatment
Anatolian Current Medical Journal
Aims: This study was conducted to review the clinical, laboratory, and ultrasound findings of patients with a confirmed post-operative adnexal torsion diagnosis in a tertiary university hospital and to reflect the management of adnexal torsion. Methods: 44 patients (ages [15,44] with a median of 30 yr) who had an operation at Ankara University Hospital Gynecology and Obstetrics Clinics between October 2013 and February 2021 and in whom the preoperative diagnosis of adnexal torsion was confirmed intraoperatively were included in this retrospective study. Patients’ complaints, existing risk factors, physical examination, laboratory, and radiological findings were evaluated. Results: 26 (65%) of the patients complained about acute abdominal pain isolated on one side. Torsion was observed on the right side in 29 (66%) patients. Risk factors: History of ovarian torsion in 1 patient (2%), in vitro fertilization treatment in 5 (11%) patients, 4 (9%) of which also had ovarian hyperstimulati...
Journal of Advanced Zoology
Introduction: Adnexal torsion is a significant source of morbidity, and nonspecific signs can make diagnosis difficult. Early identification is crucial to avoid ovarian infarction and the likelihood of related infertility. Our study aims to assess the clinicopathological profile of adnexal torsion cases through retrospective analysis from a tertiary care teaching hospital in southern India. Methods: This retrospective study was carried out in the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital in Tamil Nadu, India. Data was collected on women with surgically proven adnexal torsion from January 2019 to December 2022. Proper ethics permission was obtained, and informed consent was taken from all the patients prior to the commencement of the study. The subjects' confidentiality was maintained. The data was represented using detailed descriptive analyses, medians, and percentages. Statistical analysis was carried out using Microsoft Excel 2007 and IBM S...
Adnexal Torsion: A Retrospective Analysis From a Tertiary Care Teaching Hospital in Northern India
Cureus, 2021
Background Adnexal torsion is an acute gynecological emergency presenting with acute abdomen which can be missed owing to non-specific symptoms. Among reproductive-age women, conservative surgery is preferred. The present study was a retrospective analysis of adnexal torsion cases reported to a tertiary care teaching hospital in Northern India. The purpose of the study was to describe the demography, clinical features, diagnostic and treatment modalities, and prognosis of adnexal torsion cases. Methods Surgically proven adnexal torsion case records were retrieved and data were entered in an excel sheet from a period of two and half years from January 2018 to June 2020. Results There were 28 cases with an age range of 7-85 years (median age 24 years) with lower abdominal pain and nausea/vomiting symptoms. The majority were in the reproductive age group (71.4%). A Colour Doppler was done which detected 75% (12/16) of the ovarian torsion cases. The size of the adnexal torsion was 5-10 cm in 60.7% with right-sided torsion seen in 57.14%. Detorsion and salpingo-oophorectomy was done in 14 (50%) and 11 (39.2%) cases, respectively. Histopathological examination revealed hemorrhagic/necrotic infarcts (54.2%) and dermoid cysts (33.3%). Conclusions Owing to non-specific symptoms, adnexal torsion is diagnosed with strong clinical suspicion as routine ultrasonography diagnosed only 7.1% in the present study. Conservative surgery is preferred in the reproductive age group.
Adnexal Torsion: Difficulty in Diagnosis and Management
Medical Bulletin of Haseki, 2018
To investigate both the diagnostic value of Dopplerultrasonography and factors influencing surgical intervention in patients with adnexal torsion (AT). Methods: We retrospectively examined medical records of 66 women with AT in a single center between January 2007 and December 2016. Results: Forty-three out of 66 patients (65.1%) with AT were correctly diagnosed preoperatively. On Doppler examination, reduced ovarian arterial blood velocity was observed in 39 patients (59.1%); and the sensitivity was 0.67. AT was diagnosed in 49 patients (74.2%) via laparotomy, and the number of patients who were subjected to radical treatment was higher than that of patients managed with conservative treatment (54.6% vs 45.4%). Although there was no difference in the surgical approaches (laparoscopy vs laparotomy) between the groups, age, gravidity, parity, body mass index, and ovarian cyst size were significantly lower in patients who were treated conservatively (p<0.05). Conclusion: The diagnostic value of Doppler examination for AT is limited and the decision for surgical management should not be delayed based on Doppler results. Early age, low gravidity, parity and body mass index, and small size of ovarian cyst on ultrasonography were indication for conservative treatment, whereas black-bluish macroscopic appearance had no influence on the preference towards the selection of treatment.
Adnexal Torsion In Females Of Reproductive Age Group Presenting With Lower Abdominal Pain ., Indo Am
The main objective of the study is to find the accuracy of pelvic ultrasound in diagnosing adnexal torsion in females of reproductive age group presenting with lower abdominal pain. Material and methods: This descriptive study was conducted in Jinnah Hospital, Lahore during March 2019 to November 2019. All women aged between 14 and 45 years with acute lower abdominal pain suggestive of ovarian or adnexal were identified. Among the selected subjects, only those with positive ultrasound findings suggestive of ovarian/adnexal torsion and underwent laparoscopic surgery were included in this study. Results: The data was collected from 100 patients. 43 (13.3%) were confirmed as cases of ovarian torsion by surgery and other surgical diagnoses were appendicitis (24.8%), hemorrhagic cyst (22.9%), ectopic pregnancy (21.1%), and others (18.0%). The highest and the lowest mean age was specified to women suffering from ovarian torsion (24.9 ± 8.0 years) and hemorrhagic cyst (26.9 ± 7.8 years). Twenty eight women (8.7%) were pregnant who suffered the most from ovarian torsion compared with non-pregnant women (35.7% versus 11.1%, p < 0.001). Conclusion: It is concluded that increment in the number of cases of adnexal torsion demands specific, quick, and accurate diagnostic measure. Ultrasound has been the most successful technique in this scenario.
Adnexal Torsion: Clinical Study in a Tertiary Care Center in India
Journal of SAFOMS
Aim and objective: Adnexal torsion is a rare gynecological emergency. It involves females of all age groups. It requires early diagnosis and intervention in order to save the adnexa from irreversible injury. Our study elaborates on the clinical presentation, diagnosis, and management of adnexal torsion in a tertiary care center in India. Study design: Prospective study. Materials and methods: This is a clinical study conducted at Sri Ramachandra Institute of Research and Higher Education over a period of 1 year-January 2018 to January 2019. Results: Most cases of adnexal torsion presented with diffuse pain abdomen (64.2%), nausea, and vomiting (42.8%). About 60% were mainly found in the reproductive age group of 20-30 years. Five antenatal cases with adnexal torsion were observed (11%). Polycystic ovaries (21.4%) and hypothyroidism (50%) were the notable risk factors associated. Size more than 5 cm were increasingly associated with adnexal torsion. Ultrasound was used as a primary imaging modality although in few cases like pregnancy, large masses in which ultrasound was inconclusive computerised tomography (CT) and magnetic resonance imaging (MRI) were more convincing. Laproscopy was the preferred mode of intervention with an attempt to conserve the ovary in child-bearing age group. However, 24% of cases were converted to laparotomy in view of large size of the mass or hemodynamic instability. Conclusion: Adnexal torsion is one of the rare emergencies, which requires an expertise team for early diagnosis using imaging and clinical symptoms. Prompt surgical intervention is required to preserve the ovarian tissue especially in younger age group.
Adnexal torsion-five-year retrospective study
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: Adnexal torsion is one of the gynecologic emergency conditions requiring prompt diagnosis and surgical treatment to save the ovarian function. This retrospective study is intended to analyze the clinical manifestations and treatment in a tertiary care center. Methods: This is a retrospective study Case records during five-year period of February 2012-2017 in PSG Institute of Medical Sciences and research, Coimbatore, India. Results: Adnexal torsion was seen in all age groups and commonly in reproductive age. It was seen in few pregnant patients also. Lower abdominal pain of acute onset associated with nausea and vomiting was the commonest clinical feature. Ovarian cyst and PCOD were the common risk factors predisposing torsion. Though ultra sound was the common modality used, the diagnosis was done based on strong clinical suspicion with surgical confirmation. The ovaries were preserved in some patients of reproductive age group. Conclusions: Adnexal torsion is one of the gynecologic emergencies. The symptoms and signs are nonspecific and may not have a confirmatory lab or imaging study. Hence a strong clinical suspicion followed by prompt surgical management in both pregnant and non-pregnant patients of any age group saves the ovary and further complications.
Adnexal Torsion - Management and Review of Literature
Journal of Evolution of medical and Dental Sciences, 2014
BACKGROUND: Ovarian torsion presents as acute abdominal pain and early surgical management is required to prevent further adnexal damage. It accounts for 3% of all cases of acute abdominal pain in adult women. As signs and symptoms can mimic other acute abdominal conditions, the preoperative diagnosis often remains a challenge for primary care physicians. AIMS AND OBJECTIVES: To study the characteristics of adnexal torsion and factors influencing adnexal preservation. MATERIAL AND METHODS: All 14 patients were admitted in a tertiary endoscopic surgical unit with the complaints of pain in abdomen, nausea and vomiting of varying duration. The minimum duration of symptoms was 3 days and a maximum of 1 year. All patients were evaluated by ultrasound examination preoperatively. The time interval between the onset of symptoms and definitive surgery varied from 3 days to one year. Laparoscopic approach was offered to all patients except one where the patient was antenatal at 10 weeks of ge...
Conservative laparoscopic approach to adnexal torsion
Archives of Gynecology and Obstetrics, 2008
Objective To evaluate the conservative laparoscopic approach to adnexal torsion during reproductive age. Methods We present 18 patients with adnexal torsion between January 1997 and December 2005. Patients treated conservatively were controlled by ultrasonography during the postoperative period. Results Of 18 patients with adnexal torsion, 12 patients were treated by conservative laparoscopic surgery after detorsion, one patient with only tubal torsion had undergone laparoscopic salpengectomy. Laparoscopy was converted to laparotomy after laparoscopic detorsion in Wve cases. Of Wve patients in this group, four patients was performed cystectomy, one patient salpingo-oopherectomy. Conservative treatment was carried out in 16 of 18 cases with adnexal torsions. Conclusion Conservative management is a safe way to preserve the ovarian function during the reproductive period.