The Diagnosis and Treatment of Ovarian Torsion in Childhood and Adolescence

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  • 卵巣茎捻転の診断および治療法に関する検討

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[Purpose] The aim of this study was to evaluate the clinical features of ovarian torsion (OT) and discuss the optimal management of this disease in childhood. [Materials and methods] Female patients who presented with acute abdomen and a concurrent ovarian cyst on abdominal computed tomography (CT) were suspected to have OT, and they underwent surgical procedures for that condition. Seven patients underwent emergency laparoscopy between 2000 and 2011. [Result] The average age of the patients was 11.3±4.2 years, and the average diameter of the ovaries was 75±26mm. Of the 7 patients, 5 were confirmed to have OT after laparoscopy. In these cases, CT revealed a high-density area around the ovary. We believed that an ovary presenting a severe ischemic change on laparoscopy was nonviable ; therefore, we performed oophorectomy in the 5 cases. However, in 3 of the 5 cases, viable oocytes were identified in the resected specimen. Malignant lesions were absent in all cases. A contralateral ovarian cyst developed after surgery in 1 case. [Conclusion] Laparoscopic examination is useful for the diagnosis and treatment of OT. In addition, detorsion and reproduction-preserving procedures are recommended even if the ovary shows severe ischemic change on laparoscopy.

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