Adnexal torsion: can the adnexa be saved?
OBJECTIVE
Our purpose was to identify which cases of adnexal torsion may be managed with adnexal conservation.


METHODS
A retrospective chart review was conducted on all patients diagnosed with adnexal torsion between February 1983 and February 1993 at four hospitals in the Emory University system.


RESULTS
Fifty-nine patients ranging in age from 23 months to 73 years (mean 31.9 years) were reviewed. Almost half of the patients were nulliparous. Lower abdominal pain (83%) and an adnexal mass (72%) were the most common presenting findings, but in general clinical findings were nonspecific. Most patients were treated with extirpative therapy of the affected adnexa. Untwisting of the adnexa was performed in 10 patients; however, adnexal conservation was accomplished in only one patient. There were no thromboembolic complications in any of the patients.


CONCLUSIONS
Adnexal torsion is a diagnostic challenge, often with nonspecific symptoms. There is growing evidence that untwisting the involved adnexa to observe for tissue reperfusion and viability is safe. However, significant delay in surgical intervention may result in irreversible tissue necrosis, rendering the adnexa unsalvageable.
Bayer
A I
AI
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30322.
Wiskind
A K
AK
D000290:Adnexa Uteri / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005831:Genital Diseases, Female / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D014102:Torsion Abnormality