Adnexal Torsion: Difficulty in Diagnosis and Management
Yıl: 2018 Cilt: 56 Sayı: 3 Sayfa Aralığı: 187 - 191 Metin Dili: İngilizce DOI: 10.4274/haseki.25633 İndeks Tarihi: 15-05-2019
Adnexal Torsion: Difficulty in Diagnosis and Management
Öz: Aim: To investigate both the diagnostic value of Dopplerultrasonographyand factors influencing surgical intervention inpatients with adnexal torsion (AT).Methods: We retrospectively examined medical records of 66 womenwith AT in a single center between January 2007 and December 2016.Results: Forty-three out of 66 patients (65.1%) with AT were correctlydiagnosed preoperatively. On Doppler examination, reduced ovarianarterial blood velocity was observed in 39 patients (59.1%); and thesensitivity was 0.67. AT was diagnosed in 49 patients (74.2%) vialaparotomy, and the number of patients who were subjected to radicaltreatment was higher than that of patients managed with conservativetreatment (54.6% vs 45.4%). Although there was no difference in thesurgical approaches (laparoscopy vs laparotomy) between the groups,age, gravidity, parity, body mass index, and ovarian cyst size weresignificantly lower in patients who were treated conservatively (p<0.05).Conclusion: The diagnostic value of Doppler examination for ATis limited and the decision for surgical management should not bedelayed based on Doppler results. Early age, low gravidity, parity andbody mass index, and small size of ovarian cyst on ultrasonographywere indication for conservative treatment, whereas black-bluishmacroscopic appearance had no influence on the preference towardsthe selection of treatment.
Anahtar Kelime: Konular:
Adneksiyal Torsiyon: Tanı ve Tedavide Zorluk
Öz: Amaç: Adneksiyal torsiyonlu (AT) hastalarda Doppler ultrasonografinin tanısal değeri ve cerrahi müdahaleyi etkileyen faktörlerin araştırılmasıdır. Yöntemler: Ocak 2007-Aralık 2016 tarihleri arasında, tek merkezde AT’si bulunan 66 kadının tıbbi kayıtları retrospektif olarak incelendi. Bulgular: Operasyon öncesi 66 hastanın 43’ünde (%65,1) doğru tanı koyulmuştu. Doppler incelemede, 39 hastada (%59,1) overyan arterde akım kaybı olduğu izlendi; ve duyarlılık 0,6 idi. Kırk dokuz hastada (%74,2) AT tanısı laparotomi ile koyulmuştu ve radikal tedavi konservatif tedaviye göre daha fazla hastada uygulanmıştı (%54,6’ya karşı %45,4). Her ne kadar cerrahi yaklaşımlara (laparoskopiye karşı laparotomi) göre gruplar arasında fark olmasa da; yaş, gravidite, parite, vücut kütle indeksi ve over kist boyutu, konservatif tedavi uygulanan hastalarda anlamlı olarak daha düşüktü (p<0,05). Sonuç: AT için Doppler incelemesinin tanı değeri sınırlıdır ve cerrahi tedavi kararı Doppler sonuçlarına göre geciktirilmemelidir. Erken yaş, düşük gravidite, parite ve vücut kitle indeksi, ultrasonografide küçük çaplı over kisti konservatif tedavi yönünde etkiliyken, siyah-mavimsi makroskopik görünümün tedavi seçimi üzerinde etkisinin olmadığı gösterildi.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- Huchon C, Fauconnier A. Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol 2010;150:8-12.
- Mellor A, Grover S. Auto-amputation of the ovary and fallopian tube in a child. Aust N Z J Obstet Gynaecol 2014;54:189-90.
- Focseneanu MA, Omurtag K, Ratts VS, Merritt DF. The auto-amputated adnexa: a review of findings in a pediatric population. J Pediatr Adolesc Gynecol 2013;26:305-13.
- Fitzhugh VA, Shaikh JR, Heller DS. Adnexal torsion leading to death of an infant. J Pediatr Adolesc Gynecol 2008;21:295-7.
- Sasaki KJ, Miller CE. Adnexal torsion: review of the literature. J Minim Invasive Gynecol 2014;21:196-202.
- Chang HC, Bhatt S, Dogra VS. Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics 2008;28:1355-68.
- Nizar K, Deutsch M, Filmer S, Weizman B, Beloosesky R, Weiner Z. Doppler studies of the ovarian venous blood flow in the diagnosis of adnexal torsion. J Clin Ultrasound 2009;37:439-9.
- Pansky M, Abargil A, Dreazen E, Golan A, Bukovsky I, Herman A. Conservative management of adnexal torsion in premenarchal girls. J Am Assoc Gynecol Laparosc 2000;7:121-4.
- Bozdag G, Demir B, Calis PT, Zengin D, Dilbaz B. The impact of adnexal torsion on antral follicle count when compared with contralateral ovary. J Minim Invasive Gynecol 2014;21:632-5.
- Yasa C, Dural O, Bastu E, Zorlu M, Demir O, Ugurlucan FG. Impact of laparoscopic ovarian detorsion on ovarian reserve. J Obstet Gynaecol Res 2017;43:298-302.
- Balci O, Icen MS, Mahmoud AS, Capar M, Colakoglu MC. Management and outcomes of adnexal torsion: a 5-year experience. Arch Gynecol Obstet 2011;284:643-6.
- Sahlu Z, Negash S, Yusuf L. Adnexal torsion a five-years retrospective review in two hospitals. Ethiop Med J 2014;52:155-64.
- Yuk JS, Kim LY, Shin JY, Choi DY, Kim TY, Lee JH. A national population-based study of the incidence of adnexal torsion in the Republic of Korea. Int J Gynaecol Obstet 2015;129:169- 70.
- Erdemoğlu M, Kuyumcuoglu U, Guzel AI. Clinical experience of adnexal torsion: evaluation of 143 cases. J Exp Ther Oncol 2011;9:171-4.
- Dilbaz B, Karcaaltincaba D, Karasu Y, Karadag B, Ellibes A, Kocak M. The clinical parameters affecting the management of adnexal torsion. Saudi Med J 2011;32:1080-1.
- Chang HC, Bhatt S, Dogra VS. Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics 2008:28:1355-68.
- Kupesic S, Playsic BM. Adnexal torsion: color Doppler and three-dimensional ultrasound. Abdom Imaging 2010:35:602- 6.
- Nizar K, Deutsch M, Filmer S, Weizman B, Beloosesky R, Weiner Z. Doppler studies of the ovarian venous blood flow in the diagnosis of adnexal torsion. J Clin Ultrasound 2009:37:436-9.
- Cohen SB, Wattiez A, Seidman DS, et al. Laparoscopy versus laparotomy for detorsion and sparing of twisted ischemic adnexa. JSLS 2003;7:295-9.
- Oelsner G, Cohen SB, Soriano D, Admon D, Mashiach S, Carp H. Minimal surgery for the twisted ischaemic adnexa can preserve ovarian function. Hum Reprod 2003;18:2599-602.
- Eitan R, Galoyan N, Zuckerman B, Shaya M, Shen O, Beller U. The risk of malignancy in post-menopausal women presenting with adnexal torsion. Gynecol Oncol 2007;106:211-4.
| APA | Tas E, Yavuz A (2018). Adnexal Torsion: Difficulty in Diagnosis and Management. , 187 - 191. 10.4274/haseki.25633 |
| Chicago | Tas Emre Erdem,Yavuz Ayse Filiz Adnexal Torsion: Difficulty in Diagnosis and Management. (2018): 187 - 191. 10.4274/haseki.25633 |
| MLA | Tas Emre Erdem,Yavuz Ayse Filiz Adnexal Torsion: Difficulty in Diagnosis and Management. , 2018, ss.187 - 191. 10.4274/haseki.25633 |
| AMA | Tas E,Yavuz A Adnexal Torsion: Difficulty in Diagnosis and Management. . 2018; 187 - 191. 10.4274/haseki.25633 |
| Vancouver | Tas E,Yavuz A Adnexal Torsion: Difficulty in Diagnosis and Management. . 2018; 187 - 191. 10.4274/haseki.25633 |
| IEEE | Tas E,Yavuz A "Adnexal Torsion: Difficulty in Diagnosis and Management." , ss.187 - 191, 2018. 10.4274/haseki.25633 |
| ISNAD | Tas, Emre Erdem - Yavuz, Ayse Filiz. "Adnexal Torsion: Difficulty in Diagnosis and Management". (2018), 187-191. https://doi.org/10.4274/haseki.25633 |
| APA | Tas E, Yavuz A (2018). Adnexal Torsion: Difficulty in Diagnosis and Management. Haseki Tıp Bülteni, 56(3), 187 - 191. 10.4274/haseki.25633 |
| Chicago | Tas Emre Erdem,Yavuz Ayse Filiz Adnexal Torsion: Difficulty in Diagnosis and Management. Haseki Tıp Bülteni 56, no.3 (2018): 187 - 191. 10.4274/haseki.25633 |
| MLA | Tas Emre Erdem,Yavuz Ayse Filiz Adnexal Torsion: Difficulty in Diagnosis and Management. Haseki Tıp Bülteni, vol.56, no.3, 2018, ss.187 - 191. 10.4274/haseki.25633 |
| AMA | Tas E,Yavuz A Adnexal Torsion: Difficulty in Diagnosis and Management. Haseki Tıp Bülteni. 2018; 56(3): 187 - 191. 10.4274/haseki.25633 |
| Vancouver | Tas E,Yavuz A Adnexal Torsion: Difficulty in Diagnosis and Management. Haseki Tıp Bülteni. 2018; 56(3): 187 - 191. 10.4274/haseki.25633 |
| IEEE | Tas E,Yavuz A "Adnexal Torsion: Difficulty in Diagnosis and Management." Haseki Tıp Bülteni, 56, ss.187 - 191, 2018. 10.4274/haseki.25633 |
| ISNAD | Tas, Emre Erdem - Yavuz, Ayse Filiz. "Adnexal Torsion: Difficulty in Diagnosis and Management". Haseki Tıp Bülteni 56/3 (2018), 187-191. https://doi.org/10.4274/haseki.25633 |
