Unusual presentation of antenatal ovarian torsion: free-floating abdominal cysts. Our experience and surgical management.
BACKGROUND
Abdominal cystic formations in newborns are relatively common and often diagnostic suspicion arises before birth as a result of ultrasound scans carried out during pregnancy. Prenatal ovarian torsion is a rare condition very difficult to manage in the first days of life. We report and discuss the management of prenatal ovarian torsion with a free-floating abdominal cyst detected on prenatal ultrasound.


METHODS
We recorded the cases of antenatal abdominal cysts detected on ultrasound at the Department of Antenatal Diagnosis between January 2003 and January 2007. Only patients with a free-floating cyst were included in the study. Clinical and surgical findings were then recorded.


RESULTS
Two out of 57 patients underwent surgery for a free-floating abdominal cyst during the second day of life. Postnatal ultrasound, Doppler ultrasound, and laparoscopic exploration were useful to identify an unusual presentation of antenatal ovarian torsion with a complete atresia of the Fallopian tube.


CONCLUSIONS
The cases reported in this study suggest that a good clinical approach to all cases of abdominal cysts detected on prenatal ultrasound scans require postnatal Doppler and abdominal ultrasound with a laparoscopic exploration. Free-floating abdominal cysts are rare but, at the same time, strictly correlated with autoamputation of the ovary/Fallopian tube complex.
Zampieri
Nicola
N
Department of Surgical Sciences, Pediatric Surgical Unit, University of Verona, Policlinico, Verona, Italy. dr.zampieri@libero.it
Scirè
Gabriella
G
Zambon
Carla
C
Ottolenghi
Alberto
A
Camoglio
Francesco Saverio
FS
D000005:Abdomen; D003560:Cysts / Q000000981:diagnostic imaging / Q000196:embryology* / Q000601:surgery; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000000981:diagnostic imaging / Q000196:embryology*; D011247:Pregnancy; D014463:Ultrasonography