Retrospective analysis of 14 patients who managed for adnexal torsion during pregnancy

Abstract

Objective: To assess some clinical characteristics of patients who were treated for adnexal torsion during pregnancy. Methods: Medical records of 14 pregnant women with adnexal torsion who were surgically treated at our hospital between 1 st January 2011 to 30 th October 2015 were screened. In addition to the demographic features obtained from medical records, presenting complaints, physical examination and ultrasonographic findings, type of surgery, histopathologic findings, route of deliveries and complications were all recorded. Results: Mean age of patients included in the study was 27.8 ± 3.9 years, mean gravidity was 2.8 ± 1.8 and mean gestational age was 14.4 weeks. Most commonly seen complaint was pelvic pain followed by emesis and vomiting. All participants underwent abdominal surgery showing an adnexal mass with a mean volume of 48.4 ± 12.1 cm2. Also all participants underwent Doppler ultrasound assessment showing decreased ovarian blood flow. Among 14 patients, 3 of them were managed by laparoscopy while remaining was treated by laparotomy. Detorsion and cystectomy were performed in 10 patients while detorsion was performed in 3 patients, in 1 patient after detorsion no blood flow was observed therefore salpingo-oophorectomy was performed due to overt necrotic appearance. Most commonly seen histopathologic type was mature cystic teratoma. No operative complication was observed. Conclusion: Adnexal torsion should be kept in mind in pregnant presenting with acute abdominal pain. Early diagnosis and treatment are important for organ preserving surgery. Key words: Pregnancy, adnexal torsion, ultrasonography