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

Authors : Şeyma OSMANLIOĞLU, Koray Görkem SAÇINTI, Merve AYDIN, Y. Emre ŞÜKÜR

Pages : 282-286

Doi:10.38053/acmj.1298225

View : 62 | Download : 79

Publication Date : 2023-07-28

Article Type : Research Paper

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 insert ignore into journalissuearticles values(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 insert ignore into journalissuearticles values(65%); of the patients complained about acute abdominal pain isolated on one side. Torsion was observed on the right side in 29 insert ignore into journalissuearticles values(66%); patients. Risk factors: History of ovarian torsion in 1 patient insert ignore into journalissuearticles values(2%);, in vitro fertilization treatment in 5 insert ignore into journalissuearticles values(11%); patients, 4 insert ignore into journalissuearticles values(9%); of which also had ovarian hyperstimulation syndrome and 2 insert ignore into journalissuearticles values(5%); of them had polycystic ovary syndrome, and finally, 28 insert ignore into journalissuearticles values(65%); patients had increased ovarian size on ultrasound. Ovarian blood flow was not observed in 25 insert ignore into journalissuearticles values(81%); of 31 patients who underwent transvaginal Doppler ultrasound. Preoperative blood examination showed anemia insert ignore into journalissuearticles values(Hb 10000/mm³); in 26 insert ignore into journalissuearticles values(59%);, and an increase of neutrophil-lymphocyte ratio insert ignore into journalissuearticles values(NLR); insert ignore into journalissuearticles values(>3); in 36 insert ignore into journalissuearticles values(82%);. Laparoscopy was performed in 37 insert ignore into journalissuearticles values(84%); patients and laparotomy in 7 insert ignore into journalissuearticles values(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.
Keywords : Adnexal torsion, laparoscopy, ovary, ultrasound, neutrophil lymphocyte ratio