Faculty Collaboration Database

Management of pediatric ovarian torsion: evidence of follicular development after ovarian preservation. Surgery 2018 Mar;163(3):547-552

Date

01/14/2018

Pubmed ID

29329768

DOI

10.1016/j.surg.2017.11.019

Scopus ID

2-s2.0-85040131108 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

PURPOSE: This study reviews contemporary management and follow-up of pediatric ovarian torsion.

METHODS: This is a retrospective series of patients from birth to 19 years undergoing operative management of ovarian torsion from 2012 to 2016.

RESULTS: We studied 43 girls who underwent 51 operations for ovarian torsion. The median age was 8.3 years. Ultrasound was utilized for diagnosis in 24/29 patients (83%) evaluated in a children's hospital. In contrast, computed tomography was used initially in 7 cases (50%) in children imaged at non-children's hospitals before transfer. Initial operation for ovarian torsion was completed laparoscopically in 38 (88%). Overall, ovarian preservation was performed in 37 (86%) patients, while 6 (13%) underwent oophorectomy. Indications for oophorectomy included 5 infants with in utero torsion and an 18-year-old with a suspected malignancy. In girls with acute ovarian torsion, the oophorectomy rate was reduced to 2%. Postoperatively, 1 patient developed a small bowel obstruction requiring operation after laparoscopic ovarian detorsion. Recurrent torsion occurred in 3 patients (7%). In total, 34 patients underwent postoperative ovarian imaging. A total of 25 (74%) had follicles visualized in the previously torsed ovary.

CONCLUSION: Ovarian-sparing operations for acute torsion are safe and result in ovarian salvage and preservation of follicular development in more than 70% of children and adolescents.

Author List

Walker SK, Lal DR, Boyd KP, Sato TT

Authors

Kevin P. Boyd DO Chief, Associate Professor in the Radiology department at Medical College of Wisconsin
Dave Lal MD, MPH Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Laparoscopy
Ovarian Diseases
Ovarian Follicle
Ovariectomy
Recurrence
Retrospective Studies
Torsion Abnormality
Treatment Outcome
Young Adult