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A retrospective cohort study on the clinical course of ovarian torsion in females with abdominal pain


Obstetrics & Gynecology International Journal
Kariman Ghazal MD,1,2,3 El Hassan Jihad MD,1,4 Ahmad Bayrouti MD,1 Georges Yared MD5,6

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Abstract

Objective: The goal of this study was to examine the clinical and ultrasonographic features of females who presented with abdominal discomfort and had ovarian torsion against those who did not.
Methods: This was a cohort study that looked back included all female patients who presented to a referral private clinic with pelvic and/or abdominal pain between January 2017 and December 2020. Patients who were clinically diagnosed with torsion but had negative intra-operative findings were excluded. Patients who met the criteria were separated into two groups (ovarian torsion vs. no torsion).Symptoms including the type, location and duration of pain, presence of nausea and vomiting, abdominal tenderness, presence of adnexal masses at digital examination, ultrasound findings, pre-operative diagnosis, final diagnosis, as well as surgical management were recorded.
Results: During the research period, a total of 65 female patients came with abdominal discomfort, with 17 (26.2%) having ovarian torsion and 48 (73.8%) not having torsion. 1 (5.9%) of the 17 patients with torsion were in their teenage years, 14 (87.4%) were in their reproductive years, and 2 (11.8%) were 51 years or older. All patients who had torsion presented with nausea and vomiting while none of the patients who did not have torsion had nausea and vomiting (p-value<0.0001). As for pain, 38 (79.2%) had moderate pain in the no torsion group compared to none in those who had torsion since all patients who had torsion had severe pain compared to 10 (20.8%) of those who did not have torsion (p-value<0.0001). Eight patients were pregnant, 5 without torsion and 3 with torsion. The length of discomfort in the torsion group was substantially longer than in the non-torsion group (52.6555.02 days vs. 16.3115.85, p-value0.0001, respectively). Three patients were menopausal, 1 with no torsion and 2 had torsion. Around 58% of the patients without torsion had negative Doppler findings for simple cyst compared to 23.5% of those with torsion. All patients who had torsion underwent surgery and all patients without torsion had regression of pelvic mass. For those who had torsion, 35.3% had their ovary removed, 58.8% had the cyst removed while ovary conserved, and 5.9% had drainage for the cyst.
Conclusion: Using a combination of presenting symptoms and ultrasonography, ovarian masses may be identified and ovarian torsion suspected. Torsion must be detected early in order to get conservative therapy and maintain the reproductive capacity of younger girls.

Keywords

ovarian torsion, abdominal pain, ultrasound

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