Surgical tactic in treatment of ovarian masses in adolescents

2015 ◽  
Vol 6 (1) ◽  
pp. 81-86
Author(s):  
Svetlana Alekseevna Leontyeva ◽  
Elena Aleksandrovna Ulrikh ◽  
Nadezda Anatolyevna Kokhreidze
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Ovarian Tumor ◽  
Acute Abdominal Pain ◽  
Malignant Tumors ◽  
Ovarian Torsion ◽  
Reproductive Status ◽  
Gonadotropin Stimulation ◽  
Ovarian Masses ◽  
Status Of Women

Ovarian lesions in children are most frequently diagnosed in pubertal period. That could be associated with increased gonadotropin stimulation in this period. Most of the andexal masses in adolescents are benign. Malignant tumors of the ovary account less than 2 % in girls. Every girl with ovarian tumor and acute abdominal pain requires urgent differential diagnostic intervention and/or surgical treatment. The proportion of ovarian torsion is 2-3 % of all cases of abdominal pain in girls. This condition is an emergent gynecological pathology. One of the main aim of surgical treatment in young is to preserve fertility. Different surgery tactics in cases of ovarian masses in adolescents are reviewed in the article. The reproductive status of women underwent treatment for ovarian masses in childhood requires further investigations.

scholarly journals Ovarian Masses-Applicable IOTA ADNEX Model versus Morphological Findings for Accurate Diagnosis and Treatment

2021 ◽  
Vol 11 (22) ◽  
pp. 10789
Author(s):  
Tudor Butureanu ◽  
Demetra Socolov ◽  
Daniela Roxana Matasariu ◽  
Alexandra Ursache ◽  
Ana-Maria Apetrei ◽  
...  
Keyword(s):  
At Risk ◽  
Surgical Treatment ◽  
Ovarian Tumor ◽  
Malignant Tumors ◽  
Benign Tumors ◽  
Adnexal Masses ◽  
Borderline Tumors ◽  
Benign Ovarian Tumor ◽  
Significant Difference ◽  
Ovarian Masses

A common problem in gynecological practice is the differential diagnosis of the ovarian masses. The clinician must apply the IOTA (International Ovarian Tumor Analysis) ADNEX (Assessment of Different Neoplasia in the Adnexa) model criteria to evaluate the risk of benign, borderline or malignant tumors. The aim of this study was to verify if the IOTA ADNEX model is a practical tool to be used before surgery and if there is a significant difference between IOTA ADNEX criteria and histological findings. A prospective single center study was performed between January 2017 and December 2019 in Obstetrics and Gynecology Hospital “Cuza-Voda”, Iasi, Romania. The study included 230 patients between 17 and 74 years old diagnosed with persistent adnexal masses. We applied the IOTA ADNEX model protocol predicting the risk of benign, borderline or malignant masses. The golden standard remains the histological diagnosis of the surgically removed mass. The patients that had been diagnosed using ultrasonography with persistent adnexal masses between 30 and 291 mm were operated on in our clinic. In our study. the majority of patients had benign ovarian tumor mass, these being 223 (96.96%) patients, from whom, according to IOTA ADNEX protocol, the correspondence was: 91.8–99.7% at risk of benign tumors, 0.3–4.5% at risk of borderline tumors and 0.3–8.2% at risk of malignant masses. Unexpected findings were obtained from the malignant group that included five patients (2.17%) with the following correspondence: 96.1–99% at risk of benign tumors, 0.6–2.4% at risk of borderline tumors and 1–3.9% at risk of malignant masses. After applying the IOTA ADNEX model criteria, the patients with a suspicion of malignant disease were correctly guided towards surgical treatment in an oncological center. In our hospital, surgical treatment was only proposed to those patients with high suspicion of benign masses.

scholarly journals Torsion of the Ovary in Infancy, a Rare Emergency; A Case Report

2021 ◽  
pp. 90-96
Author(s):  
Abdelilah Radi ◽  
Karima Larbi Ouassou ◽  
Amal Hassani ◽  
Rachid Abilkassem ◽  
Aomar Agadr ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Clinical Evaluation ◽  
Clinical Picture ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Ovarian Torsion ◽  
Positive Diagnosis ◽  
Hemorrhagic Risk ◽  
Made In

Torsion of the ovary is a rare condition whose diagnosis remains difficult given the non-specificity of the clinical picture as well as the difficulty of clinical evaluation, especially in young girls. It is a surgical emergency because it involves the vital prognosis by the hemorrhagic risk, and functional prognosis by the risk of infertility. The clinical picture is dominated by acute abdominal pain. Our work reports the case of a 2-year-old girl in whom the diagnosis of ovarian torsion was made in front of an atypical clinical picture. Laparoscopy is the method of choice for making a positive diagnosis and performing a conservative procedure as described in this work.

scholarly journals Analysis of the risk of ovarian torsion in 49 consecutive pediatric patients treated at a single institution

2019 ◽  
Vol 2 (2) ◽  
pp. e000009
Author(s):  
Koshiro Sugita ◽  
Takafumi Kawano ◽  
Mukai Motoi ◽  
Toshihiro Muraji ◽  
Shun Onishi ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
White Cell Count ◽  
Ovarian Torsion ◽  
Imaging Findings ◽  
Single Institution ◽  
Exact Test ◽  
Cystic Masses ◽  
Ovarian Masses

PurposeAn early diagnosis of ovarian torsion is sometimes difficult due to variable clinical symptoms and non-specific imaging findings. We retrospectively reviewed patients with pediatric ovarian masses manifesting torsion.MethodsFifty-eight ovarian masses (55 episodes) in 49 non-neonatal patients treated from April 1984 to March 2017 were retrospectively analyzed. The Mann-Whitney U test and Fisher’s exact test were used for the statistical analysis.ResultsThe median age of these 55 episodes was 10.5 years old (range 1.0–23.0). Thirty-three patients presented with abdominal pain. Forty-five tumors and 13 cystic masses were resected and diagnosed pathologically (50 benign and 8 malignant). Torsion was identified in 15 cases (25.9%) at operation. The torsion masses were all benign, and 8 ovaries (53.3%) were successfully preserved. Comparing the torsion cases with the non-torsion cases, only the white cell count was significantly higher in the torsion cases (p=0.0133) and in the patients presented with abdominal pain (p=0.0068). The duration of abdominal pain was significantly shorter in ovary preserved cases than in oophorectomy cases.ConclusionThe white blood cell may be a helpful indicator of the presence of torsion as well as the need for surgery.

scholarly journals A rare case of ovarian torsion in a pregnant patient

2021 ◽  
Vol 11 (1) ◽  
pp. 255
Author(s):  
Swati Kumari
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Diagnostic Delay ◽  
Pregnant Patient ◽  
Ovarian Torsion ◽  
Adnexal Torsion ◽  
Venous Flow ◽  
Presenting Symptoms ◽  
Prompt Treatment ◽  
Gynecologic Emergency

Torsion of the ovary is the total or partial rotation of the adnexa around its vascular axis or pedicle. It is an uncommon cause of acute abdominal pain in females, and it is a gynecologic emergency. The majority of the cases present in the pregnant (22.7%) than in non-pregnant (6.1%) women. Diagnostic delay can result in loss of the ovary. This twisting initially obstructs venous flow, which causes engorgement and edema. The engorgement can progress until arterial flow is also compromised, leading to ischemia and infarction. The increased use of ovarian stimulation and assisted reproductive technology has led to an increase in the risk of adnexal torsion, particularly in pregnant women or women with ovarian hyperstimulation syndrome (OHSS). The differential diagnosis of adnexal torsion is particularly difficult in combination with OHSS or pregnancy, as abdominal pain, nausea and vomiting can be presenting symptoms of hyperstimulation or pregnancy as well. Here, we report a case of ovarian torsion occurring in pregnancy in which diagnostic delay occurred due to confusion with OHSS leading to oophorectomy. Fertility conservation may have been possible in case of earlier diagnosis and prompt treatment.

scholarly journals Paediatric ovarian torsion: a case report and review of literature

2020 ◽  
Vol 9 (6) ◽  
pp. 2638
Author(s):  
Umang . ◽  
Harleen Kaur Cheema ◽  
Sidharth Khullar ◽  
Madhu Nagpal
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Conservative Surgery ◽  
Ovarian Torsion ◽  
High Clinical Suspicion ◽  
Abdominal And Pelvic Pain ◽  
Intra Abdominal Infection ◽  
Prompt Diagnosis

Ovarian torsion is a surgical emergency, can result in ovarian loss, intra-abdominal infection and even death. Paediatric ovarian torsion is a rare condition, requires high clinical suspicion and prompt diagnosis. Diagnosis is a challenge since signs and symptoms are similar to those of other causes of acute abdominal pain such as appendicitis, gastroenteritis, urinary tract infection, renal colic or other conditions of acute abdominal and pelvic pain. Here, authors describe a case of a 4-year-old girl with a presentation of acute abdominal pain, treated empirically elsewhere. After investigations, a provisional diagnosis of ovarian torsion was made and patient was taken up for surgery. Intraoperatively, ovary was found to be necrosed. Detorsion was tried but ovary was unsalvageable. Right sided salpingectomy with oophorectomy was performed. Conservative surgery by laparoscopic detorsion can be tried in cases of ischemia but if necrosis has already set in, then salpingo-oophorectomy has to be performed.

scholarly journals Ovarian torsion in a 20-year-old patient

CJEM ◽  
2006 ◽  
Vol 8 (02) ◽  
pp. 126-129 ◽  
Author(s):  
Chris Martin ◽  
Kirk Magee
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Clinical Presentation ◽  
Acute Abdominal Pain ◽  
Signs And Symptoms ◽  
Ovarian Torsion ◽  
High Index ◽  
Reproductive Age ◽  
The Difference ◽  
High Index Of Suspicion

ABSTRACTOvarian torsion is an uncommon gynecological emergency that requires prompt recognition and treatment. It may present with nonspecific signs and symptoms, and should be considered in any female with acute abdominal pain. The diagnosis is based on an awareness of the relevant risk factors, the clinical presentation, and a high index of suspicion. Timely investigation and management can make the difference between ovarian loss and salvage — an outcome of great importance in the population of reproductive age females.

scholarly journals Sudden/nocturnal onset of acute abdominal pain, lasting less than a day and accompanied by vomiting: a tell-tale sign of ovarian torsion

2010 ◽  
Vol 7 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Roy Mashiach ◽  
Shikma Bar-On ◽  
Valentina Boyko ◽  
David Stockheim ◽  
Motti Goldenberg ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Ovarian Torsion

scholarly journals Diagnostic laparoscopy in acute abdominal pain

2019 ◽  
Vol 6 (4) ◽  
pp. 1104
Author(s):  
Ravichandran Subramaniam
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Diagnostic Laparoscopy ◽  
Acute Abdominal Pain ◽  
Tertiary Care ◽  
Medical Science ◽  
Ovarian Torsion ◽  
Care Hospital ◽  
Number Of Patients ◽  
Study Results

Background: Acute Abdominal pain is an important surgical problem in all age groups. Early diagnosis is needed to rule out life threatening conditions. Diagnostic laparoscopy is a modern useful tool in giving proper treatment for all needed individuals. The aim of the present endeavor is to study the use of laparoscope in patients with acute pain over the abdomen, to diagnose and confirm conditions like acute appendicitis, appendicular abscess, doudenal perforation, ileal perforation. Ovarian torsion. mass formation, etc. where clinical and imaging studies are inconclusive.Methods: This study was conducted in the tertiary care hospital and the Department of General Surgery, Melmaruvathur Adhiparasakthi Institute of Medical Science and Research, Melmaruvathur. The period of study was from June 2017 to May 2018. All patients coming to the hospital with acute abdominal pain in the age group of ten years to seventy years were included in this study. Results: Majority of the patients had the findings relevant to the correct clinical diagnosis. However significant number of patients had unexpected findings and so the diagnosis was changed, and treatment also changed. Total 100 patients were included in this prospective study. 79 patients were found to have acute appendicitis. Duodenal perforation seen in 7 patients. Jejunal perforation seen in 2 patients. Mesenteric ischemia seen in 1 patient. Acute cholecystitis seen in 3 patients. Gall bladder perforation seen in 1 patient. Ectopic pregnancy was seen in 2 patients. Ovarian torsion seen in 3 patients. Ileocecal tuberculosis seen in 1 patient. No abnormality seen in 1 patient.Conclusions: The best approach in abdominal pain is to do diagnostic laparoscopy and proceed, rather than going for open laparotomy. Diagnostic laparoscopy gives all benefits of minimal invasive surgery. Not much of pain, shorter period of hospitalization, small scars, low infection rates and most importantly, accurate diagnosis and the correct treatment of most of the intra-abdominal conditions are the gifted things.

scholarly journals Age specific clinicopathological profile of ovarian mass

2019 ◽  
Vol 6 (2) ◽  
pp. 18-22
Author(s):  
Laxmi R.C. Karki ◽  
Nishchal Bogati
Keyword(s):  
Germ Cell ◽  
Ovarian Tumor ◽  
Malignant Tumors ◽  
Germ Cell Tumors ◽  
Clinical Profile ◽  
Age Group ◽  
Ovarian Mass ◽  
Peak Incidence ◽  
Neoplastic Lesion ◽  
Ovarian Masses

Introductions: Ovarian cancer is seventh leading cause of cancer death among women. Ovarian mass has age specific occurrence and may may help in screening and management plans. This study was conducted to determine the age-wise clinical profile of the ovarian mass. Methods: This review done to analyse the histologically diagnosed ovarian masses in cases operated during three years at Patan Hospital, Patan Academy of Health Sciences, Nepal. Clinical profile of the patients and age-wise distribution of histological types of ovarian mass were analyzed descriptively using Microsoft Excel. Results: Peak incidence of ovarian tumor was in age group of 20-29 years with 93 (36%) cases out of 258 ovarian masses. All eight malignant tumors were in age group of ≥40 years. Neoplastic masses were 188 (72.9%), 95 (50.5%) germ cell tumor. In 70 (27.1%) non-neoplastic lesion, corpus luteal cyst were 24 (34.3%). Conclusions: Peak incidence of ovarian tumor was seen in age group of 20-29 years. Germ cell tumors accounted for half of the neoplastic lesions. All malignant ovarian tumors were in found in age group ≥40 years.

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