The clinical management of ovarian torsion: case series of 66 patients
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- Kawashima Atsushi
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Wada Shinichiro
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Koizumi Aki
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Yamamoto Masae
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Minowa Kaoru
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Suzuki Yukio
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Watanabe Takayuki
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Takenaka Hiroshi
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Nakajima Ayako
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Fukushi Yoshiyuki
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Fujino Takafumi
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Sato Chikara
- Department of Obstetrics and Gynecology, Teine Keijinkai Hospital
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- Shinohara Toshiya
- Department of Pathology, Teine Keijinkai Hospital
Bibliographic Information
- Other Title
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- 当科における卵巣腫瘍茎捻転66例の検討
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Abstract
Objectives: We evaluated the accuracy of using enhanced computed tomography (CT) findings in the diagnosis of ovarian torsion and using preoperative levels of C-reactive protein (CRP) as a marker for adnexal necrosis.<BR>Subjects: Sixty-six patients who were surgically treated for ovarian torsion between January 2009 and August 2012 at our institution were included in this study.<BR>Methods: We retrospectively studied: (1) the relationship between the presence of pathological necrosis and the time from the onset of ovarian torsion to the operation, (2) the relationship between pathological necrosis and the preoperative CRP value, (3) differences between macroscopic and pathological findings of necrosis, (4) the incidence of observing significant findings (fallopian tube thickening or twisted pedicle) related to adnexal torsion when using enhanced CT for the diagnosis of ovarian torsion.<BR>Results: (1) There was a significant difference (P = 0 .03) in the incidence of pathological necrosis in patients who had experienced ovarian torsion of < 12 h (25% incidence of necrosis) and patients who had experienced ovarian torsion of ≥ 24 hr (60% incidence of necrosis). (2) Twenty-two cases of ovarian torsion were CRP positive and 44 cases were CRP negative. There was a significant difference in the percentage of the CRP positive cases and CRP negative cases which showed pathological necrosis, (63.6% and 31.8%, respectively, P = 0.02). (3) Forty-one of the 66 torsion cases showed macroscopic necrosis; however, 29.2% of these were not pathological necrosis. (4) Of the 66 torsion cases, 75.6% showed some significant findings on enhanced CT scans.<BR>Conclusions: (1) A prolonged time from the onset of ovarian torsion to an operation leads to pathological necrosis. (2) The CRP value is a good surrogate marker for the presence of pathological necrosis. (3) Macroscopic findings sometimes misdiagnose ovarian necrosis. (4) Enhanced CT helps in the accurate diagnosis of ovarian torsion.
Journal
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- JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY
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JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY 29 (1), 264-270, 2013
JAPAN SOCIETY OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY AND MINIMALLY INVASIVE THERAPY
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Details 詳細情報について
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- CRID
- 1390001205346640512
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- NII Article ID
- 130003395882
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- ISSN
- 18845746
- 18849938
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- Text Lang
- en
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed