Risk Factors, Symptoms, and Treatment of Ovarian Torsion in Children: The Twelve-Year Experience of One Center
Abstract Objective To assess risk factors, clinical findings and mode of diagnosis and treatment in premenarchal children with surgically verified ovarian torsion (OT). Study Design A retrospective case review (Canadian Task Force Classification II-2). Setting Teaching and research hospital, a terti...
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| Veröffentlicht in: | Journal of minimally invasive gynecology 2012, Vol.19 (1), p.29-33 |
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| container_title | Journal of minimally invasive gynecology |
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| creator | Tsafrir, Ziv, MD Azem, Foad, MD Hasson, Joseph, MD Solomon, Efrat, BSc Almog, Benny, MD Nagar, Hagith, MD Lessing, Joseph B., MD Levin, Ishai, MD |
| description | Abstract Objective To assess risk factors, clinical findings and mode of diagnosis and treatment in premenarchal children with surgically verified ovarian torsion (OT). Study Design A retrospective case review (Canadian Task Force Classification II-2). Setting Teaching and research hospital, a tertiary center. Patients Premenarchal children with surgically verified OT. Interventions Patients underwent either laparoscopy or laparotomy. Results Twenty-two cases of OT in 20 premenarchal girls (median age 12 years) were identified. Three cases involved recurrent torsion after detorsion without cystectomy. The main presenting symptoms were sudden pain and vomiting. Six patients underwent Doppler examinations, and all demonstrated an abnormal flow. Seventeen interventions were by laparoscopy. Conservative management, mainly detorsion with additional cyst drainage or cystectomy, was performed in 19 cases (86.4%). Oophoropexy was performed in 3 cases (13.6%). Pathologic examination demonstrated 5 simple cysts and 1 dermoid cyst. Conclusions Ovarian torsion in premenarchal girls usually presents with intermittent abdominal pain and abdominal tenderness. Other signs and symptoms are nonspecific. When performed, Doppler imaging may assist in diagnosing ovarian torsion in children. Detorsion followed by cystectomy may prevent recurrence. |
| doi_str_mv | 10.1016/j.jmig.2011.08.722 |
| format | Article |
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Study Design A retrospective case review (Canadian Task Force Classification II-2). Setting Teaching and research hospital, a tertiary center. Patients Premenarchal children with surgically verified OT. Interventions Patients underwent either laparoscopy or laparotomy. Results Twenty-two cases of OT in 20 premenarchal girls (median age 12 years) were identified. Three cases involved recurrent torsion after detorsion without cystectomy. The main presenting symptoms were sudden pain and vomiting. Six patients underwent Doppler examinations, and all demonstrated an abnormal flow. Seventeen interventions were by laparoscopy. Conservative management, mainly detorsion with additional cyst drainage or cystectomy, was performed in 19 cases (86.4%). Oophoropexy was performed in 3 cases (13.6%). Pathologic examination demonstrated 5 simple cysts and 1 dermoid cyst. Conclusions Ovarian torsion in premenarchal girls usually presents with intermittent abdominal pain and abdominal tenderness. Other signs and symptoms are nonspecific. When performed, Doppler imaging may assist in diagnosing ovarian torsion in children. Detorsion followed by cystectomy may prevent recurrence.</description><identifier>ISSN: 1553-4650</identifier><identifier>EISSN: 1553-4669</identifier><identifier>DOI: 10.1016/j.jmig.2011.08.722</identifier><identifier>PMID: 22014543</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdominal Pain - etiology ; Adolescent ; Child ; Child, Preschool ; Doppler ; Drainage ; Female ; Humans ; Infant ; Obstetrics and Gynecology ; Ovarian Cysts - complications ; Ovarian Cysts - surgery ; Ovarian Diseases - complications ; Ovarian Diseases - diagnostic imaging ; Ovarian Diseases - surgery ; Ovarian torsion ; Premenarchal treatment ; Recurrence ; Retrospective Studies ; Risk Factors ; Surgery ; Torsion Abnormality - complications ; Torsion Abnormality - diagnostic imaging ; Torsion Abnormality - surgery ; Ultrasonography ; Vomiting - etiology</subject><ispartof>Journal of minimally invasive gynecology, 2012, Vol.19 (1), p.29-33</ispartof><rights>AAGL</rights><rights>2012 AAGL</rights><rights>Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-ab5bb8c53ca7fa70e815337929f0c000ceca261c29df6b388011a14975c63d563</citedby><cites>FETCH-LOGICAL-c410t-ab5bb8c53ca7fa70e815337929f0c000ceca261c29df6b388011a14975c63d563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jmig.2011.08.722$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22014543$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsafrir, Ziv, MD</creatorcontrib><creatorcontrib>Azem, Foad, MD</creatorcontrib><creatorcontrib>Hasson, Joseph, MD</creatorcontrib><creatorcontrib>Solomon, Efrat, BSc</creatorcontrib><creatorcontrib>Almog, Benny, MD</creatorcontrib><creatorcontrib>Nagar, Hagith, MD</creatorcontrib><creatorcontrib>Lessing, Joseph B., MD</creatorcontrib><creatorcontrib>Levin, Ishai, MD</creatorcontrib><title>Risk Factors, Symptoms, and Treatment of Ovarian Torsion in Children: The Twelve-Year Experience of One Center</title><title>Journal of minimally invasive gynecology</title><addtitle>J Minim Invasive Gynecol</addtitle><description>Abstract Objective To assess risk factors, clinical findings and mode of diagnosis and treatment in premenarchal children with surgically verified ovarian torsion (OT). Study Design A retrospective case review (Canadian Task Force Classification II-2). Setting Teaching and research hospital, a tertiary center. Patients Premenarchal children with surgically verified OT. Interventions Patients underwent either laparoscopy or laparotomy. Results Twenty-two cases of OT in 20 premenarchal girls (median age 12 years) were identified. Three cases involved recurrent torsion after detorsion without cystectomy. The main presenting symptoms were sudden pain and vomiting. Six patients underwent Doppler examinations, and all demonstrated an abnormal flow. Seventeen interventions were by laparoscopy. Conservative management, mainly detorsion with additional cyst drainage or cystectomy, was performed in 19 cases (86.4%). Oophoropexy was performed in 3 cases (13.6%). Pathologic examination demonstrated 5 simple cysts and 1 dermoid cyst. Conclusions Ovarian torsion in premenarchal girls usually presents with intermittent abdominal pain and abdominal tenderness. Other signs and symptoms are nonspecific. When performed, Doppler imaging may assist in diagnosing ovarian torsion in children. Detorsion followed by cystectomy may prevent recurrence.</description><subject>Abdominal Pain - etiology</subject><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Doppler</subject><subject>Drainage</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Obstetrics and Gynecology</subject><subject>Ovarian Cysts - complications</subject><subject>Ovarian Cysts - surgery</subject><subject>Ovarian Diseases - complications</subject><subject>Ovarian Diseases - diagnostic imaging</subject><subject>Ovarian Diseases - surgery</subject><subject>Ovarian torsion</subject><subject>Premenarchal treatment</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Torsion Abnormality - complications</subject><subject>Torsion Abnormality - diagnostic imaging</subject><subject>Torsion Abnormality - surgery</subject><subject>Ultrasonography</subject><subject>Vomiting - etiology</subject><issn>1553-4650</issn><issn>1553-4669</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi0EoqXwBzgg37iQ4I84jhFCQqsWkCpVouHAyXKcCXWa2IudXdh_j9MtPXDgNHN43leaZxB6SUlJCa3fjuU4ux8lI5SWpCklY4_QKRWCF1Vdq8cPuyAn6FlKIyFcElI_RScsZypR8VPkv7p0iy-MXUJMb_D1Yd4uYc6b8T1uI5hlBr_gMOCrvYnOeNxm0AWPncebGzf1Efw73N4Abn_BtIfiO5iIz39vITrwFu6iHvAm10B8jp4MZkrw4n6eoW8X5-3mc3F59enL5uNlYStKlsJ0ousaK7g1cjCSQEMF51IxNRBLCLFgDaupZaof6o43TVZgaKWksDXvRc3P0Otj7zaGnztIi55dsjBNxkPYJa0ok0ooKjPJjqSNIaUIg95GN5t40JToVbMe9apZr5o1aXTWnEOv7ut33Qz9Q-Sv1wy8PwKQj9w7iDrZOx29i2AX3Qf3__4P_8Tt5LyzZrqFA6Qx7KLP-jTViWmir9dHr3-muZBKVfE_ZLCibQ</recordid><startdate>2012</startdate><enddate>2012</enddate><creator>Tsafrir, Ziv, MD</creator><creator>Azem, Foad, MD</creator><creator>Hasson, Joseph, MD</creator><creator>Solomon, Efrat, BSc</creator><creator>Almog, Benny, MD</creator><creator>Nagar, Hagith, MD</creator><creator>Lessing, Joseph B., MD</creator><creator>Levin, Ishai, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2012</creationdate><title>Risk Factors, Symptoms, and Treatment of Ovarian Torsion in Children: The Twelve-Year Experience of One Center</title><author>Tsafrir, Ziv, MD ; Azem, Foad, MD ; Hasson, Joseph, MD ; Solomon, Efrat, BSc ; Almog, Benny, MD ; Nagar, Hagith, MD ; Lessing, Joseph B., MD ; Levin, Ishai, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-ab5bb8c53ca7fa70e815337929f0c000ceca261c29df6b388011a14975c63d563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Abdominal Pain - etiology</topic><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Doppler</topic><topic>Drainage</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Obstetrics and Gynecology</topic><topic>Ovarian Cysts - complications</topic><topic>Ovarian Cysts - surgery</topic><topic>Ovarian Diseases - complications</topic><topic>Ovarian Diseases - diagnostic imaging</topic><topic>Ovarian Diseases - surgery</topic><topic>Ovarian torsion</topic><topic>Premenarchal treatment</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Torsion Abnormality - complications</topic><topic>Torsion Abnormality - diagnostic imaging</topic><topic>Torsion Abnormality - surgery</topic><topic>Ultrasonography</topic><topic>Vomiting - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tsafrir, Ziv, MD</creatorcontrib><creatorcontrib>Azem, Foad, MD</creatorcontrib><creatorcontrib>Hasson, Joseph, MD</creatorcontrib><creatorcontrib>Solomon, Efrat, BSc</creatorcontrib><creatorcontrib>Almog, Benny, MD</creatorcontrib><creatorcontrib>Nagar, Hagith, MD</creatorcontrib><creatorcontrib>Lessing, Joseph B., MD</creatorcontrib><creatorcontrib>Levin, Ishai, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of minimally invasive gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tsafrir, Ziv, MD</au><au>Azem, Foad, MD</au><au>Hasson, Joseph, MD</au><au>Solomon, Efrat, BSc</au><au>Almog, Benny, MD</au><au>Nagar, Hagith, MD</au><au>Lessing, Joseph B., MD</au><au>Levin, Ishai, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors, Symptoms, and Treatment of Ovarian Torsion in Children: The Twelve-Year Experience of One Center</atitle><jtitle>Journal of minimally invasive gynecology</jtitle><addtitle>J Minim Invasive Gynecol</addtitle><date>2012</date><risdate>2012</risdate><volume>19</volume><issue>1</issue><spage>29</spage><epage>33</epage><pages>29-33</pages><issn>1553-4650</issn><eissn>1553-4669</eissn><abstract>Abstract Objective To assess risk factors, clinical findings and mode of diagnosis and treatment in premenarchal children with surgically verified ovarian torsion (OT). Study Design A retrospective case review (Canadian Task Force Classification II-2). Setting Teaching and research hospital, a tertiary center. Patients Premenarchal children with surgically verified OT. Interventions Patients underwent either laparoscopy or laparotomy. Results Twenty-two cases of OT in 20 premenarchal girls (median age 12 years) were identified. Three cases involved recurrent torsion after detorsion without cystectomy. The main presenting symptoms were sudden pain and vomiting. Six patients underwent Doppler examinations, and all demonstrated an abnormal flow. Seventeen interventions were by laparoscopy. Conservative management, mainly detorsion with additional cyst drainage or cystectomy, was performed in 19 cases (86.4%). Oophoropexy was performed in 3 cases (13.6%). Pathologic examination demonstrated 5 simple cysts and 1 dermoid cyst. Conclusions Ovarian torsion in premenarchal girls usually presents with intermittent abdominal pain and abdominal tenderness. Other signs and symptoms are nonspecific. When performed, Doppler imaging may assist in diagnosing ovarian torsion in children. Detorsion followed by cystectomy may prevent recurrence.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>22014543</pmid><doi>10.1016/j.jmig.2011.08.722</doi><tpages>5</tpages></addata></record> |
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| subjects | Abdominal Pain - etiology Adolescent Child Child, Preschool Doppler Drainage Female Humans Infant Obstetrics and Gynecology Ovarian Cysts - complications Ovarian Cysts - surgery Ovarian Diseases - complications Ovarian Diseases - diagnostic imaging Ovarian Diseases - surgery Ovarian torsion Premenarchal treatment Recurrence Retrospective Studies Risk Factors Surgery Torsion Abnormality - complications Torsion Abnormality - diagnostic imaging Torsion Abnormality - surgery Ultrasonography Vomiting - etiology |
| title | Risk Factors, Symptoms, and Treatment of Ovarian Torsion in Children: The Twelve-Year Experience of One Center |
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