title: Torsion of the previously normal uterine adnexa. Evaluation of the correlation between the pathological changes and the clinical characteristics.
abstract: BACKGROUND
  Treatment of adnexal torsion remains a clinical dilemma when future fertility is wanted. The purpose of this study was to evaluate the correlation between the pathological changes and the clinical characteristics on patients having torsion of the previously normal uterine adnexa which may help us decide whether detorsion is worthwhile.
  
  
  METHODS
  A retrospective study of 69 patients undergoing surgical intervention for adnexal torsion was performed. Among them, 13 patients diagnosed with torsion of the previously normal adnexa were identified. Their clinical and pathological features were compared.
  
  
  RESULTS
  Extensive hemorrhagic necrosis of the twisted ovary was observed in five patients, and each of them had their duration of torsion last 48 hours or longer. Three of 13 cases (23.1%) with torsion of the previously normal adnexa had local thrombus formation within the twisted adnexa. Their duration of torsion varied from 18 hours to 288 hours.
  
  
  CONCLUSIONS
  The likelihood of preserving viable ovarian tissue is significantly decreased if the duration of torsion lasts 48 hours or longer. Local thrombus formation in the twisted adnexa cannot be predicted simply from the duration of torsion.
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei.
authors.forename: M
authors.initials: M
authors.lastname: Chen
authors.forename: C D
authors.initials: CD
authors.lastname: Chen
authors.forename: Y S
authors.initials: YS
authors.lastname: Yang
mesh_terms: D000290:Adnexa Uteri / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D005260:Female; D006470:Hemorrhage; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D009336:Necrosis; D010053:Ovary / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014102:Torsion Abnormality / Q000150:complications / Q000473:pathology; D014591:Uterine Diseases / Q000150:complications / Q000473:pathology*