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Update on the management of ovarian torsion in children and adolescents
Abdul Ghani Nur Azurah, Zakaria Wan Zainol, Ani Amelia Zainuddin, Pei Shan Lim, Aqmar Suraya Sulaiman, Beng Kwang Ng
Kuala Lumpur, Malaysia
Author Affiliations: Department of Obstetrics and Gynaecology, UKM Medical Centre, Kuala Lumpur, Malaysia (Nur Azurah AG, Wan Zainol Z, Zainuddin AA, Lim PS, Sulaiman AS, Ng BK)
Corresponding Author: Abdul Ghani Nur Azurah, MBBS, MOG (UKM), MD, Department of Obstetrics and Gynaecology, UKM Medical Centre, Kuala Lumpur, Malaysia (Email: nurazurahag@gmail.com; azurah@ppukm.ukm.edu.my)
doi: 10.1007/s12519-014-0536-3
Background: Ovarian torsion is commonly seen in young girls. Unfortunately it is often misdiagnosed because of its non-specific symptoms and lack of diagnostic modalities. This article focuses on the diagnostic challenge and also the changes in the management of ovarian torsion.
Data sources: We reviewed original reports on the management of ovarian torsion in young girls published from 1984 till 2014. A literature search was conducted by electronic scanning of five electronic database: MEDLINE, EMBASE, SCI, SSCI and CINAHL. In addition, relevant papers and review articles were hand-searched. The search was limited to English language and human studies. The search was conducted by combining the textwords "ovarian torsion", "adnexal torsion", "adolescents" and "oophoropexy".
Results: There are no specific symptoms that can be identified as a pathognomonic feature of ovarian torsion. Ultrasound is a useful diagnostic tool, but it is not always reliable in absence of an enlarged ovary. Laparoscopic detorsion is recognized as the mainstay of treatment regardless the condition of the ovaries. Reports have shown favorable ovarian function after detorsion. The role of oopheropexy remains controversial.
Conclusions: Clinicians should be aware of ovarian torsion in girls presenting with abdominal pain. A timely management in this young population can help preserve their ovaries and fertility.
World J Pediatr 2015;11(1):35-40
Key words: adolescents;
oophoropexy;
ovarian torsion
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