title: Outcome Following Detorsion of Torsed Adnexa in Children.
abstract: OBJECTIVE
  To examine the postoperative course and outcomes of young females with ovarian torsion treated with detorsion and ovarian preservation. The secondary objective was to determine which operative findings correlated with higher follicular counts following detorsion.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary academic center.
  
  
  METHODS
  29 females (mean age 10.3 ± 4.9 y) who underwent surgery for ovarian torsion with detorsion and ovarian preservation at our institution between July 2007 and July 2010 and who had follow-up pelvic ultrasonography available for review.
  
  
  METHODS
  None.
  
  
  METHODS
  Surgical findings, postoperative complications, and follicular counts on follow-up ultrasonography.
  
  
  RESULTS
  Mean duration of abdominal pain on presentation was 77.5 ± 78.8 h. The detorsed ovary was described as "dusky/purple" in 21 cases (72.4%), "normal" in 1 (3.4%), "necrotic" in 1 (3.4%), and not described in 6 (20.7%). All pubertal patients resumed menstrual function. No patients required reoperation for removal of the salvaged ovary. There were no instances of postoperative fever or concern for ovarian venous thrombosis. Average timing of follow-up ultrasonography was 8.1 ± 6.7 months, with 28 patients (96.6%) showing ovarian follicles on the affected side (mean 4.6 ± 1.9 and 4.7 ± 3.3 follicles on the right and left ovary, respectively). No correlation was found between the side affected, gross appearance of the torsed ovary or the number of follicles found on follow-up ultrasonography.
  
  
  CONCLUSIONS
  Detorsion with ovarian preservation is a safe and effective treatment, and should be considered the primary treatment for girls with ovarian torsion, even for those with ovaries that appear necrotic.
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. Electronic address: xmcampos@bcm.edu.
authors.forename: Xiomara M
authors.initials: XM
authors.lastname: Santos
authors.affiliation: Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Darrell L
authors.initials: DL
authors.lastname: Cass
authors.affiliation: Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Dietrich
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000150:complications / Q000601:surgery*; D006080:Ovarian Follicle / Q000502:physiology; D012189:Retrospective Studies; D014102:Torsion Abnormality / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome
keywords: Outcome following detorsion; Ovarian preservation; Ovarian torsion