Adnexal torsion in very young girls: diagnostic pitfalls.
OBJECTIVE
Evaluation of cases of young girls diagnosed with adnexal torsion.


METHODS
Retrospective cohort study of 39 girls born between January 1980 and January 2000 who presented with acute abdominal pain and/or the diagnosis adnexal torsion in the Groene Hart Hospital. Seven patients, aged 6-13 years, with adnexal torsion were further evaluated.


RESULTS
In three patients, it was possible to save the adnexa. Only the time relapse between the onset of complaints and the surgical intervention correlated with the presence of microscopic necrosis in the ovary. Bluish-black appearance of an ovary did not correlate with the presence of microscopic necrosis.


CONCLUSIONS
Early recognition and treatment are essential to minimise the risk of decreased fertility after adnexal torsion in young girls. We therefore advocate prompt diagnostic laparoscopy and detorsion of the adnexa. In case a cyst is present, it should not be resected, but checked on a regular basis using ultrasound.
Emonts
Marieke
M
Department of Gynaecology and Obstetrics, Groene Hart Hospital, Post Box 1098, 2800 BB Gouda, The Netherlands.
Doornewaard
Heleen
H
Admiraal
J Co'tje F
JC
D015746:Abdominal Pain / Q000209:etiology*; D000208:Acute Disease; D000291:Adnexal Diseases / Q000175:diagnosis* / Q000601:surgery; D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D010535:Laparoscopy; D009426:Netherlands; D010053:Ovary / Q000473:pathology; D012189:Retrospective Studies; D014102:Torsion Abnormality / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome