title: Surgical Approach to Ovarian Torsion in Children.
abstract: OBJECTIVE
  Ovarian torsion in children is a relatively rare cause of acute abdominal pain. This study evaluates the diagnosis and treatment of ovarian torsion with an emphasis on conservative treatment approaches including the long-term follow-up results.
  
  
  METHODS
  Patients with surgically treated ovarian torsions between December 2006 and February 2014 were included in this retrospective study. The patient population consisted of 41 patients with 42 ovaries involved. The mean age was 11 ± 3.9 (range, 1-17) years. The most common presenting symptom was abdominal pain.
  
  
  METHODS
  All patients underwent preoperative pelvic color Doppler ultrasonography that identified torsion in 34 (81%) ovaries.
  
  
  RESULTS
  During surgery, a right-sided torsion was detected in 25 (59.5%), and a left-sided one was detected in 17 (40.5%) ovaries. An excisional surgery was used for 16 (38%) ovaries, and detorsion with conservation of the ovary was used for 26 (62%). A trend toward conservative management was seen over the years. Regular follow-up for those patients who underwent conservative surgery was done in 22 patients for a mean of 25 months (range, 1.5-83 months). Control color Doppler ultrasonographic results were within normal limits in terms of ovarian size and blood supply in 17 (77%) patients. Despite normal parenchymal echogenicity, an involved ovary was smaller in size compared to the other ovary in five patients. Ovarian follicles were present in three of them.
  
  
  CONCLUSIONS
  The ovary-sparing, conservative surgery is found to be highly successful in the presented series. Although malignancies are rarely encountered in torsed ovaries with associated masses, biopsy samples should be obtained in suspicious cases.
authors.affiliation: Department of Pediatric Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey. Electronic address: mcaglar34@yahoo.com.
authors.forename: Meltem Çağlar
authors.initials: MÇ
authors.lastname: Oskaylı
authors.affiliation: Department of Pediatric Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Çiğdem Ulukaya
authors.initials: ÇU
authors.lastname: Durakbaşa
authors.affiliation: Department of Pediatric Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Maşrabacı
authors.affiliation: Department of Pediatric Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Hüseyin Murat
authors.initials: HM
authors.lastname: Mutuş
authors.affiliation: Department of Pathology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Itır Ebru
authors.initials: IE
authors.lastname: Zemheri
authors.affiliation: Department of Pediatric Surgery, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Hamit
authors.initials: H
authors.lastname: Okur
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D010049:Ovarian Diseases / Q000601:surgery*; D012189:Retrospective Studies; D014102:Torsion Abnormality / Q000601:surgery*; D018615:Ultrasonography, Doppler, Color
keywords: Child; Detorsion; Follow-up; Ovarian torsion; Surgery