title: [Adnexal torsion during the second trimester of pregnancy: about two cases].
abstract: Acute pelvic pain during pregnancy makes the differential diagnosis more challenging. We here report two cases of adnexal torsion during the second trimester of pregnancy in order to draw attention to this diagnosis and to highlight the importance of early treatment to avoid irreversible damages due to ischemia which can be fertility-threatening. The first patient, G1P0, 20 weeks pregnant, initially presented with appendix syndrome. Exploration with a small McBurney incision showed a right ovarian necrosis, hence ovariectomy was performed. The postoperative course was uneventful. The second patient, G2P2, 26 weeks pregnant, presented to the emergency departments with acute left iliac fossa pain. Laparotomy revealed the torsion of a hydatid of Morgagni whose necrotic appearance due to twisting required hydatid ablation. No postoperative complications were noted in the two patients. Adnexal torsion is an emergency condition that should not be ignored in the case of acute pelvic pain in pregnant women. Conservative treatment represents the gold standard and proper management is necessary to avoid possible maternal and fetal complications.
authors.affiliation: Université El Manar 2, Tunis, Tunisie; Faculté de Médecine de Tunis, Tunisie; Service de Gynécologie et Obstétrique, CHU Bougatfa, Bizerte, Tunisie.
authors.forename: Amira
authors.initials: A
authors.lastname: Ayachi
authors.affiliation: Faculté de Médecine de Tunis, Tunisie; Service de Gynécologie et Obstétrique, CHU Bougatfa, Bizerte, Tunisie.
authors.forename: Zeineb
authors.initials: Z
authors.lastname: Blel
authors.affiliation: Faculté de Médecine de Tunis, Tunisie; Service de Gynécologie et Obstétrique, CHU Bougatfa, Bizerte, Tunisie.
authors.forename: Nahed
authors.initials: N
authors.lastname: Khelifa
authors.affiliation: Université El Manar 2, Tunis, Tunisie; Faculté de Médecine de Tunis, Tunisie; Service de Gynécologie et Obstétrique, CHU Bougatfa, Bizerte, Tunisie.
authors.forename: Lassaad
authors.initials: L
authors.lastname: Mkaouer
authors.affiliation: Faculté de Médecine de Tunis, Tunisie; Service de Gynécologie et Obstétrique, CHU Bougatfa, Bizerte, Tunisie.
authors.forename: Rim
authors.initials: R
authors.lastname: Bouchahda
authors.affiliation: Université El Manar 2, Tunis, Tunisie; Faculté de Médecine de Tunis, Tunisie; Service de Gynécologie et Obstétrique, CHU Bougatfa, Bizerte, Tunisie.
authors.forename: Mechaal
authors.initials: M
authors.lastname: Mourali
mesh_terms: D059787:Acute Pain / Q000209:etiology; D000291:Adnexal Diseases / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods; D009336:Necrosis; D010052:Ovariectomy / Q000379:methods; D010310:Parovarian Cyst / Q000175:diagnosis* / Q000601:surgery; D017699:Pelvic Pain / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011262:Pregnancy Trimester, Second; D014102:Torsion Abnormality / Q000175:diagnosis* / Q000601:surgery
keywords: Adnexal torsion; pregnancy; second trimester