title: Ovarian Torsion in the Normal Ovary: A Diagnostic Challenge in Postmenarchal Adolescent Girls in the Emergency Department.
abstract: BACKGROUND Ovarian torsion can be seen in the otherwise-normal ovary and is a challenging issue in the emergency department. The aims were (1) to evaluate and compare the surgically verified ovarian torsion cases in otherwise-normal ovaries and ovaries including a mass or cyst and (2) to investigate whether the normal-appearing ovaries on ultrasound examination affected the diagnosis of ovarian torsion or not. MATERIAL AND METHODS A retrospective cohort study design was used. The medical records of all postmenarchal adolescent girls with surgically verified ovarian torsion treated in a university hospital from 2010 to 2016 were reviewed. RESULTS Twenty-nine post-menarchal girls were identified. The subjects were divided into two groups. Eight girls (group 1) had ovarian torsion in a normal ovary, and twenty-one girls (group 2) had ovarian torsion including a mass or cyst. The median ages of group 1 and 2 were 13 and 14 years, respectively. Abdominal pain was the main presenting symptom for all cases in both groups. Doppler flow studies were abnormal in 6/9 (66.6%) in group 1 and 12/21 (57.1%) in group 2. The time from first admission to the operation was statistically longer in group 1 than in group 2 (34.5±24.3 hours vs. 19.5±9.2 hours, respectively; p=0.001). The longitudinal axis of uterine size was significantly shorter in group 1 than in group 2 (34.3±2.9 mm vs. 47.6±4.5 mm, respectively; p=0.001). CONCLUSIONS Ovarian torsion in adolescent girls can be seen within the otherwise-normal ovary. The normal-appearing ovaries on ultrasound in the emergency department may lead to delay in the diagnosis of ovarian torsion in adolescent girls.
authors.affiliation: Department of Obstetrics and Gynecology, Yuzuncu Yil University, Medical Faculty, Van, Turkey.
authors.forename: Erbil
authors.initials: E
authors.lastname: Karaman
authors.affiliation: Department of Pediatric Surgery, Yuzuncu Yil University, Medical Faculty, Van, Turkey.
authors.forename: Burhan
authors.initials: B
authors.lastname: Beger
authors.affiliation: Department of Obstetrics and Gynecology, Yuzuncu Yil University, Medical Faculty, Van, Turkey.
authors.forename: Orkun
authors.initials: O
authors.lastname: Çetin
authors.affiliation: Department of Pediatric Surgery, Yuzuncu Yil University, Medical Faculty, Van, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Melek
authors.affiliation: Department of Obstetrics and Gynecology, Private Lokman Hekim Hayat Hospital, Van, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Karaman
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging; D000293:Adolescent; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000000981:diagnostic imaging*; D010053:Ovary / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014102:Torsion Abnormality / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color / Q000379:methods