TY  - JOUR
T1  - Adnexal torsion: a single-center retrospective study of diagnosis and treatment
AU  - Osmanlıoğlu, Şeyma
AU  - Saçıntı, Koray Görkem
AU  - Aydın, Merve
AU  - Şükür, Y. Emre
PY  - 2023
DA  - July
DO  - 10.38053/acmj.1298225
JF  - Anatolian Current Medical Journal
JO  - Anatolian Curr Med J / ACMJ / acmj
PB  - MediHealth Academy Yayıncılık
WT  - DergiPark
SN  - 2718-0115
SP  - 282
EP  - 286
VL  - 5
IS  - 3
LA  - en
AB  - 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 (Hb10000/mm³) 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 patient’s 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.
KW  - Adnexal torsion
KW  - laparoscopy
KW  - ovary
KW  - ultrasound
KW  - neutrophil-lymphocyte ratio
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UR  - https://doi.org/10.38053/acmj.1298225
L1  - https://dergipark.org.tr/tr/download/article-file/3147511
ER  -