[Diagnosis of adnexal torsion and predictive factors of adnexal necrosis].
OBJECTIVE
To determine the most relevant findings for diagnosis of adnexal torsion and predictive factors of adnexal necrosis.


METHODS
Clinical, biological, ultrasound, pathologic and surgical findings in surgically confirmed cases of adnexal torsion treated over a five-year period in a gynaecologic emergency department were retrospectively reviewed.


RESULTS
A total of 52 cases of adnexal torsion were studied. Abdominal pain was present in 80.8%, vomiting in 13.5% and fever only in 9.6%. Leukocytosis was noted in 19 (36.5%). The most frequent ultrasound findings were ovarian enlargement in 22 patients (42.3%), ovarian cysts in 26 (50%), and hyperechogenic parenchyma with follicles along the periphery of the ovary in 13 (25%). Age over 40 years and a delay to surgery longer than 10 hours were significantly associated with diagnosis of adnexal necrosis.


CONCLUSIONS
Prompt diagnosis of adnexal torsion requires a combination of clinical, biological and radiological evidence. No predictive factors of necrosis are found. Risk of adnexal torsion is potentially increased by waiting period for surgery and patient's age.
Mazouni
C
C
Service de gynécologie-obstétrique, hôpital La Conception (APHM), 147, boulevard Baille, 13385 Marseille cedex 5, France. Chafika.Mazouni@mail.ap-hm.fr
Bretelle
F
F
Ménard
J-P
JP
Blanc
B
B
Gamerre
M
M
D000290:Adnexa Uteri / Q000473:pathology* / Q000601:surgery; D000291:Adnexal Diseases / Q000097:blood / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000367:Age Factors; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D009336:Necrosis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013997:Time Factors; D014102:Torsion Abnormality / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome