Management of adnexal torsion

Abstract

Objective: To evaluate clinical findings, operative reports, the pathological results of patients with diagnosis of adnexal torsion. Methods: Fourteen patients with diagnosis of adnexal torsion who presented to our clinic between January 2009 and March 2013 were included in this retrospective analysis. Data including clinical findings, operative reports, the pathological results were recorded. Results: The mean age of the patients was 28.1 ± 10.5 with a range of 16 to 52 years. All patients underwent ultrasonography, and a pelvic mass appearance was detected in all cases. The mean diameter of the mass was 8,04±2,96 cm. All of the patients had lower abdominal pain, nausea and vomiting. Six patients were operated laparoscopically, while eight patients had laparotomy. Detorsion and cystectomy was performed in 7 (50.0%) of the patients. Two of patients were pregnant in operation time that treated by cystectomy and detorsion of the ovaries successfully in the first and third trimester (one by laparoscopy). There was one patient of isolated fallopian tube torsion due to hydrosalpinks treated by laparoscopic salpingectomy. Two of the patients had paratubal cyst and tubal torsion. Detorsion and cystectomy by laparoscopy and salpingectomy by laparotomy were performed for these patients respectively. The most common histopathology was serous cystadenoma (28,6%). Conclusion: Adnexal torsion is a rare gynecologic emergency of women and occur in reproductive ages mostly. Prompt diagnosis and conservative treatment is important for the safety of ovaries and fallopian tubes and future fertility. J Clin Exp Invest 2014; 5 (1): 7-11

Keywords

• Adnexal torsion, conservative management, detorsion

Adneksiyal torsiyon yönetimi

Öz

Amaç: Adneksiyal torsiyon tanısı alan hastaların klinik, uygulanan operasyon ve patoloji bulgularının değerlendirilmesi Yöntemler: Ocak 2009 ile Mart 2013 tarihleri arasında kliniğimize başvurup adneksiyal torsiyon tanısı alan 14 hasta retrospektif olan çalışmamıza dahil edildi. Klinik bulgular, operasyon bulguları, patoloji sonuçlarını içeren bilgiler toplandı. Bulgular: 16-56 yaş arası olan hastaların ortalama yaşı 28,1± 10,5 idi. Bütün hastalara ultrasonografi yapıldı ve adneksiyal kitle bütün hastalarda saptandı. Ortalama kitle boyutu 8,04±2,96 cm idi. Bütün hastalarda alt abdominal ağrı, bulantı ve kusma şikayeti mevcuttu. 6 hastaya laparoskopi, 8 hastaya laparatomi uygulandı. 7 (50,0%) hastaya detorsiyon ve kistektomi yapıldı. Biri ilk trimesterda, diğeri üçüncü trimesterda olan 2 hamile hastaya kistektomi ve detorsiyon uygulandı( biri laparoskopi ile). Bir hastada hidrosalpinkse bağlı izole tubal torsiyon izlendi ve laparoskopik salpenjektomi uygulandı. İki hastada paratubal kist nedeniyle tubal torsiyon izlendi. Birine laparoskopik detorsiyon ve kistektomi, birine laparotomi ile salpenjektomi yapıldı. En sık görülen patoloji seröz kistadenomdu. (28,6 %). Sonuç: Adneksiyal torsiyon daha çok üreme çağında görülen nadir jinekolojik acillerdendir. Hızlı tanı ve konservatif yaklaşım ile over ve tubaları korumak gelecekteki fertiliteyi korumak için önemlidir.

Anahtar Kelimeler

• Adneksiyal torsiyon, konservatif yaklaşım, detorsiyon

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