title: Should the ovary always be conserved in torsion? A tertiary care institute experience.
abstract: OBJECTIVE
  The aim of this study was to analyze our experience in conserving ovarian tissue in cases of ovarian torsion, irrespective of grade of necrosis at exploration.
  
  
  METHODS
  All children with a diagnosis of ovarian torsion admitted to our hospital from January 2009 to January 2013 were included. Patients with underlying ovarian pathology were excluded.
  
  
  RESULTS
  There were 13 torsions in 12 children (one bilateral). All underwent detorsion with or without evacuation of hematoma. Follow-up ultrasonography (USG) with color Doppler was done for all 13 ovaries, which showed an ovary with good vascularity and follicular development in 12 ovaries (92%). In 76% (10 of 13) of cases, intraoperatively, the ovary was judged to be moderately to severely ischemic/necrotic. Yet, follow-up sonograms showed the ovary with follicular development in all cases except one (7%). There were no major complications in our series.
  
  
  CONCLUSIONS
  Simple detorsion, instead of traditionally advocated oophorectomy, was not accompanied by an increase in morbidity. On follow-up, almost all patients studied had functioning ovarian tissue despite the grave ischemia observed intraoperatively. Detorsion should be the procedure of choice for all cases of simple ovarian torsion in children.
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India. Electronic address: sandeshparelkar@kem.edu.
authors.forename: Sandesh V
authors.initials: SV
authors.lastname: Parelkar
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Mundada
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India.
authors.forename: Beejal V
authors.initials: BV
authors.lastname: Sanghvi
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India.
authors.forename: Prashant B
authors.initials: PB
authors.lastname: Joshi
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India.
authors.forename: Sanjay N
authors.initials: SN
authors.lastname: Oak
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India.
authors.forename: Satish P
authors.initials: SP
authors.lastname: Kapadnis
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India.
authors.forename: Shishira
authors.initials: S
authors.lastname: Shetty
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India.
authors.forename: Hemangi
authors.initials: H
authors.lastname: Athawale
authors.affiliation: Department of Pediatric Surgery, King Edward Memorial Hospital, Parel, Mumbai, India.
authors.forename: Pooja
authors.initials: P
authors.lastname: Multani
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D002648:Child; D004630:Emergencies; D005260:Female; D005334:Fever / Q000453:epidemiology / Q000209:etiology; D006406:Hematoma / Q000209:etiology / Q000601:surgery; D006552:Hernia, Inguinal / Q000150:complications; D006801:Humans; D045823:Ileus / Q000453:epidemiology / Q000209:etiology; D007511:Ischemia / Q000209:etiology / Q000601:surgery; D009336:Necrosis; D059351:Organ Sparing Treatments; D010049:Ovarian Diseases / Q000601:surgery*; D006080:Ovarian Follicle / Q000000981:diagnostic imaging; D010052:Ovariectomy / Q000706:statistics & numerical data*; D010053:Ovary / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D010060:Ovulation; D011183:Postoperative Complications / Q000453:epidemiology; D012720:Severity of Illness Index; D013536:Suture Techniques; D014102:Torsion Abnormality / Q000601:surgery*; D018615:Ultrasonography, Doppler, Color; D019564:Unnecessary Procedures
keywords: Children; Conservative management; Ovarian torsion