Adnexal torsion: a single-center retrospective study of diagnosis and treatment

Şeyma Osmanlıoğlu; Koray Görkem Saçıntı; Merve Aydın; Y. Emre Şükür

Article Details

Adnexal torsion: a single-center retrospective study of diagnosis and treatment

Authors:

Şeyma Osmanlıoğlu | Koray Görkem Saçıntı | Merve Aydın | Y. Emre Şükür

Publisher:

MediHealth Academy Yayıncılık

Main Topics:

Kadın Hastalıkları ve Doğum

Journal:

Anatolian Current Medical Journal Vol.5 Issue 3, pp.282-286

Document Type:

Article

Publication Date:

7/2023

Document Language:

English

Document ID (Org No.):

2001293477

pISSN:

2718-0115

Keywords:

Abstract:

 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 hyperstimulation syndrome and 2 5 of them had polycystic ovary syndrome, and finally, 28 65 patients had increased ovarian size on ultrasound. Ovarian blood flow was not observed in 25 81 of 31 patients who underwent transvaginal Doppler ultrasound. Preoperative blood examination showed anemia Hb12 gdL in 14 32, leukocytosis 10000mm³ in 26 59, and an increase of neutrophil-lymphocyte ratio NLR 3 in 36 82. Laparoscopy was performed in 37 84 patients and laparotomy in 7 16. Conclusion: There is no objective diagnostic tool that can definitively lead to the diagnosis of adnexal torsion. It may be recommended to use ultrasound, Doppler, and NLR in addition to clinical findings and anamnesis. Considering the consequences of delay in the treatment, the most appropriate approach would be to perform a laparoscopy if torsion is suspected. Additionally, the patients age, menopausal status, ovarian pathology, and desire for fertility are factors that should be considered in the treatment decision, and ovarian protection should be the primary goal.

 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 hyperstimulation syndrome and 2 5 of them had polycystic ovary syndrome, and finally, 28 65 patients had increased ovarian size on ultrasound. Ovarian blood flow was not observed in 25 81 of 31 patients who underwent transvaginal Doppler ultrasound. Preoperative blood examination showed anemia Hb12 gdL in 14 32, leukocytosis 10000mm³ in 26 59, and an increase of neutrophil-lymphocyte ratio NLR 3 in 36 82. Laparoscopy was performed in 37 84 patients and laparotomy in 7 16. Conclusion: There is no objective diagnostic tool that can definitively lead to the diagnosis of adnexal torsion. It may be recommended to use ultrasound, Doppler, and NLR in addition to clinical findings and anamnesis. Considering the consequences of delay in the treatment, the most appropriate approach would be to perform a laparoscopy if torsion is suspected. Additionally, the patients age, menopausal status, ovarian pathology, and desire for fertility are factors that should be considered in the treatment decision, and ovarian protection should be the primary goal.

 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 hyperstimulation syndrome and 2 5 of them had polycystic ovary syndrome, and finally, 28 65 patients had increased ovarian size on ultrasound. Ovarian blood flow was not observed in 25 81 of 31 patients who underwent transvaginal Doppler ultrasound. Preoperative blood examination showed anemia Hb12 gdL in 14 32, leukocytosis 10000mm³ in 26 59, and an increase of neutrophil-lymphocyte ratio NLR 3 in 36 82. Laparoscopy was performed in 37 84 patients and laparotomy in 7 16. Conclusion: There is no objective diagnostic tool that can definitively lead to the diagnosis of adnexal torsion. It may be recommended to use ultrasound, Doppler, and NLR in addition to clinical findings and anamnesis. Considering the consequences of delay in the treatment, the most appropriate approach would be to perform a laparoscopy if torsion is suspected. Additionally, the patients age, menopausal status, ovarian pathology, and desire for fertility are factors that should be considered in the treatment decision, and ovarian protection should be the primary goal.

 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 hyperstimulation syndrome and 2 5 of them had polycystic ovary syndrome, and finally, 28 65 patients had increased ovarian size on ultrasound. Ovarian blood flow was not observed in 25 81 of 31 patients who underwent transvaginal Doppler ultrasound. Preoperative blood examination showed anemia Hb12 gdL in 14 32, leukocytosis 10000mm³ in 26 59, and an increase of neutrophil-lymphocyte ratio NLR 3 in 36 82. Laparoscopy was performed in 37 84 patients and laparotomy in 7 16. Conclusion: There is no objective diagnostic tool that can definitively lead to the diagnosis of adnexal torsion. It may be recommended to use ultrasound, Doppler, and NLR in addition to clinical findings and anamnesis. Considering the consequences of delay in the treatment, the most appropriate approach would be to perform a laparoscopy if torsion is suspected. Additionally, the patients age, menopausal status, ovarian pathology, and desire for fertility are factors that should be considered in the treatment decision, and ovarian protection should be the primary goal.

Article Details

Adnexal torsion: a single-center retrospective study of diagnosis and treatment

Authors: Şeyma Osmanlıoğlu | Koray Görkem Saçıntı | Merve Aydın | Y. Emre Şükür

Publisher: MediHealth Academy Yayıncılık

Main Topics: Kadın Hastalıkları ve Doğum

Journal: Anatolian Current Medical Journal Vol.5 Issue 3, pp.282-286

Document Type: Article

Publication Date: 7/2023

Document Language: English

Document ID (Org No.): 2001293477

pISSN: 2718-0115

Adnexal torsion

laparoscopy

ovary

ultrasound

neutrophil-lymphocyte ratio

Issues

Authors:

Şeyma Osmanlıoğlu | Koray Görkem Saçıntı | Merve Aydın | Y. Emre Şükür

Publisher:

MediHealth Academy Yayıncılık

Main Topics:

Kadın Hastalıkları ve Doğum

Journal:

Anatolian Current Medical Journal Vol.5 Issue 3, pp.282-286

Document Type:

Article

Publication Date:

7/2023

Document Language:

English

Document ID (Org No.):

2001293477

pISSN:

2718-0115