Adnexal torsion. Organ-sparing tactics

Zalina Kimovna Batyrova; Батырова Залина Кимовна; Madina Arsenovna Chundokova; Чундокова Мадина Арсеновна; Elena Vitalievna Uvarova; Уварова Елена Витальевна; Zaira Khasanovna Kumykova; Кумыкова Заира Хасановна; Elena Petrovna Khashchenko; Хащенко Елена Петровна; Vladimir Dmitrievich Chuprynin; Чупрынин Владимир Дмитриевич; Stanislav Sergeevich Lunkov; Луньков Станислав Сергеевич; Irina Anatolievna Kiseleva; Киселева Ирина Анатольевна; Nailja Khusainovna Latypova; Латыпова Наиля Хусаиновна; Natalya Aleksandrovna Buralkina; Буралкина Наталья Александровна

doi:10.18565/aig.2017.9.148-52

Adnexal torsion. Organ-sparing tactics

Authors: Batyrova Z.K.¹, Chundokova M.A.², Uvarova E.V.¹, Kumykova Z.K.¹, Khashchenko E.P.¹, Chuprynin V.D.¹, Lunkov S.S.¹, Kiseleva I.A.¹, Latypova N.K.¹, Buralkina N.A.¹
Affiliations:
1. Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
2. N.F. Filatov City Children’s Hospital Thirteen
Issue: No 9 (2017)
Pages: 148-152
Section: Articles
URL: https://journals.eco-vector.com/0300-9092/article/view/248072
DOI: https://doi.org/10.18565/aig.2017.9.148-52
ID: 248072

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Abstract

Background. Adnexal torsion (AT) occurs in 15% of children. The choice of surgical tactics is based on visual assessment of the color of the uterine appendages. Ovariectomy is chosen when the twisted ovary is found to have a violet or blue-black color that remains after untwisting (detorsion). However, articles describing the favorable outcomes of preservation of even a seemingly nonviable ovary indicate that the blue-black color is not always confirmed by the morphological signs of necrosis, and in the late period there is recovery of blood flow and folliculogenesis in the untwisted ovary. Description. The paper describes two most illustrative clinical cases of girls with AT, in which the blue-black color suggested the absence of ovarian viability, but the long-term results of detorsion testified that a surgeon’s initial opinion is faulty. Conclusion. Pain complaints in the AT area is an encouraging clinical sign of viability of the ovary, which allows the choice of organ-sparing tactics even with its blue-black color, low vulnerability, and a lack of blood flow. Recovery of blood flow in the uterine appendage during the first 7 days after detorsion, as evidenced by pelvic Doppler ultrasound, should be considered to be a significant prognostic factor in the similar clinical picture of AT.

Keywords

adnexal torsion, girls, organ-sparing treatment, laparoscopy

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Adnexal torsion. Organ-sparing tactics

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