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Igbodike EP, Iwuala IC, Maduako RO, Eleje GU, Akinjo AO, Ubom AE, Ikechebelu JI, Onwudiegwu U, Anunobi CC. Ovarian torsion-detorsion in a 10-year premenarchial female with chronic recurrent abdominal pain misdiagnosed as 'ama-afo' in a suburb: A case report. Int J Gynaecol Obstet 2024. [PMID: 38504528 DOI: 10.1002/ijgo.15460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/05/2024] [Accepted: 02/25/2024] [Indexed: 03/21/2024]
Abstract
SynopsisThis case involved a 10‐year‐old female with recurrent abdominal pain misdiagnosed as ‘ama‐afo’. Intraoperative findings showed a left‐sided strangulated/gangrenous tubo‐ovarian mass twisted four times on its pedicle.
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Affiliation(s)
- Emeka Philip Igbodike
- Department of Obstetrics and Gynecology, Havana Specialist Hospital, Surulere, Lagos, Nigeria
- Obafemi Awolowo University Teaching Hospitals, Ile-Ife, Nigeria
| | - Ijeoma Chinyere Iwuala
- Department of Obstetrics and Gynecology, Havana Specialist Hospital, Surulere, Lagos, Nigeria
| | | | - George Uchenna Eleje
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi Campus, Awka, Anambra State, Nigeria
| | - Andrea Oludapo Akinjo
- Department of Anatomic and Molecular Pathology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
| | | | - Joseph Ifeanyichukwu Ikechebelu
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi Campus, Awka, Anambra State, Nigeria
| | - Uchenna Onwudiegwu
- Department of Obstetrics and Gynecology, Bayelsa Medical University, Yenagoa, Bayelsa State, Nigeria
| | - Charles Chidozie Anunobi
- Department of Anatomic and Molecular Pathology, College of Medicine University of Lagos, Idi-Araba, Lagos, Nigeria
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Morin CE, Karakas P, Vorona G, Sreedher G, Brian JM, Chavhan GB, Chung T, Griffin LM, Kaplan SL, Moore M, Schenker K, Subramanian S, Aquino M. The Society for Pediatric Radiology Magnetic Resonance Imaging and Emergency and Trauma Imaging Committees' consensus protocol recommendation for rapid MRI for evaluating suspected appendicitis in children. Pediatr Radiol 2024; 54:12-19. [PMID: 38049531 DOI: 10.1007/s00247-023-05819-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 12/06/2023]
Abstract
The imaging evaluation of acute abdominal pain in children with suspected appendicitis has evolved to include rapid abdominopelvic MRI (rMRI) over recent years. Through a collaborative effort between the Magnetic Resonance Imaging (MRI) and Emergency and Trauma Imaging Committees of the Society for Pediatric Radiology (SPR), we conducted a survey on the utilization of rMRI to assess practice specifics and protocols. Subsequently, we present a proposed consensus rMRI protocol derived from the survey results, literature review, and discussion and consensus between committee members.
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Affiliation(s)
- Cara E Morin
- Department of Radiology, Cincinnati Children's Hospital and University of Cincinnati College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
| | | | - Gregory Vorona
- Department of Radiology, The Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, USA
| | | | - James M Brian
- Department of Radiology, Penn State Children's Hospital, Penn State Health, Penn State College of Medicine, Hershey, USA
| | - Govind B Chavhan
- Diagnostic Imaging Department, The Hospital for Sick Children and Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Taylor Chung
- UCSF Benioff Children's Hospital Oakland, Oakland, USA
| | | | - Summer L Kaplan
- Department of Radiology Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
| | - Michael Moore
- Department of Radiology, Nemours Children's Health, Wilmington, DE, USA
| | - Kathleen Schenker
- Department of Radiology, Nemours Children's Hospital, Wilmington, DE, USA
| | | | - Michael Aquino
- Section of Pediatric Imaging, Cleveland Clinic Imaging Institute and Cleveland Clinic Lerner College of Medicine of Case Western University, Cleveland, USA
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Ulusoy O, Karakuş OZ, Ateş O, Hakgüder G, Olguner M, Akgür FM. Diagnostic failures in ovarian torsion during childhood: The effect of ovarian cyst size on the diagnostic accuracy of Doppler ultrasonography. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:660-665. [PMID: 35235217 DOI: 10.1002/jcu.23167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/05/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Oktay Ulusoy
- Department of Pediatric Surgery, Dokuz Eylul University, Izmir, Turkey
| | | | - Oğuz Ateş
- Department of Pediatric Surgery, Dokuz Eylul University, Izmir, Turkey
- Division of Pediatric Urology, Dokuz Eylul University, Izmir, Turkey
| | - Gülce Hakgüder
- Department of Pediatric Surgery, Dokuz Eylul University, Izmir, Turkey
- Division of Pediatric Urology, Dokuz Eylul University, Izmir, Turkey
| | - Mustafa Olguner
- Department of Pediatric Surgery, Dokuz Eylul University, Izmir, Turkey
- Division of Pediatric Urology, Dokuz Eylul University, Izmir, Turkey
| | - Feza Miraç Akgür
- Department of Pediatric Surgery, Dokuz Eylul University, Izmir, Turkey
- Division of Pediatric Urology, Dokuz Eylul University, Izmir, Turkey
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Bekci T, Cakir IM, Aslan S. Differentiation of affected and nonaffected ovaries in ovarian torsion with magnetic resonance imaging texture analysis. Rev Assoc Med Bras (1992) 2022; 68:641-646. [DOI: 10.1590/1806-9282.20211369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 01/03/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Tumay Bekci
- Giresun University Faculty of Medicine, Turkey
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Tielli A, Scala A, Alison M, Vo Chieu VD, Farkas N, Titomanlio L, Lenglart L. Ovarian torsion: diagnosis, surgery, and fertility preservation in the pediatric population. Eur J Pediatr 2022; 181:1405-1411. [PMID: 35094159 DOI: 10.1007/s00431-021-04352-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/04/2021] [Accepted: 12/01/2021] [Indexed: 11/03/2022]
Abstract
Ovarian torsion is rare in the pediatric population. Delayed diagnosis can significantly impact fertility. The aim of this review is to highlight current knowledge regarding clinical presentation, diagnosis, surgical management, and follow-up in the pediatric population. Whilst the presentation is often very unspecific, most children will present with sudden severe unilateral pelvic pain associated with vomiting. A key diagnostic test is pelvic ultrasonography, which may help demonstrate an asymmetric enlarged ovary with peripherally displaced follicles. In the pediatric population, ovarian torsion may occur in a normal ovary. However, underlying lesions can be found in half of cases. Benign neoplasms (teratomas or cystic lesions) represent the commonest etiology, with the risk of malignancy being less than 2%. Surgical management should be focused on fertility preservation. This is achievable through ovarian detorsion ± ovarian cystectomy ± oophoropexy to avoid recurrence. Follow-up studies demonstrate excellent recovery rates of detorsed ovaries including those with ischemic appearances. What is Known: • Ovarian torsion is a rare diagnosis in the pediatric population. • Aspecific symptoms and differential diagnoses lead to missed or delayed diagnosis increasing the risk of oophoprectomy and further infertility. What is New: • Reviewing the latest knowledge about clinical presentation, diagnostic, surgical management, and follow-up of ovarian torsion in the pediatric population. • Adiponectin was negatively associated with diastolic blood pressure and HOMA-IR, and chemerin was negatively associated with glucose.
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Affiliation(s)
- Alexandra Tielli
- Department of Pediatric Emergency Care, APHP - Hôpital Robert Debré, 48 Boulevard Serurier, 75019, Paris, France
| | - Andrea Scala
- Department of Abdominal Surgery, NHS, Guildford, UK
| | - Marianne Alison
- Department of Pediatric Radiology, APHP - Hôpital Robert Debré, Paris, France.,NeuroDiderot, Inserm U1141, Equipe 5 inDev - Imaging Neurodevelopmental Phenotypes, HU I2D2, 75019, Paris, France
| | - Van Dai Vo Chieu
- Department of Pediatric Radiology, APHP - Hôpital Robert Debré, Paris, France
| | | | - Luigi Titomanlio
- Department of Pediatric Emergency Care, APHP - Hôpital Robert Debré, 48 Boulevard Serurier, 75019, Paris, France.,Paris University, INSERM U1141, DHU Protect, Paris, France
| | - Léa Lenglart
- Department of Pediatric Emergency Care, APHP - Hôpital Robert Debré, 48 Boulevard Serurier, 75019, Paris, France.
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Saberi RA, Gilna GP, Rodriguez C, Quiroz HJ, Urrechaga EM, Cioci AC, Parreco JP, Thorson CM, Sola JE, Perez EA. Ovarian Preservation and Recurrent Torsion in Children: Both Less Common Than We Thought. J Surg Res 2021; 271:67-72. [PMID: 34844056 DOI: 10.1016/j.jss.2021.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/30/2021] [Accepted: 10/13/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Surgical management of pediatric ovarian torsion includes total oophorectomy (TO) or ovarian preservation surgery (OPS). This study sought to identify factors contributing to surgical management and readmission outcomes for ovarian torsion. METHODS The Nationwide Readmission Database from 2010-2014 was used to identify patients < 18 years admitted with ovarian torsion. Patient factors, hospital characteristics, and readmission outcomes were compared by TO and OPS. Standard statistical analysis was performed and results were weighted for national estimates. RESULTS There were 6028 patients (age 13 ± 4 years) identified with ovarian torsion who underwent either TO (50%) or OPS (50%). Patients had secondary pathology of ovarian cyst (41%), benign mass (19%), and malignant mass (0.4%). OPS was more common in teaching hospitals (84% vs. 74% TO, P<0.001), patients < 13 years of age (41% vs. 37% TO, P = 0.001), and those from high-income households (51% vs. 41% TO, P<0.001). The overall readmission rate was 4%, with no difference between surgical approach (4.3% OPS vs. 4.4% TO, P = 0.882). Of those readmitted (n = 265), readmission diagnoses were cyst (10%), malignant mass (9%), benign mass (7%), and torsion (5%). The overall rate of recurrent torsion was 0.2%, with no difference between OPS and TO (< 0.3% vs. < 0.2%, P = 0.282). CONCLUSION Half of pediatric patients are undergoing TO for ovarian torsion in the U.S. and disparities exist with the utilization of OPS. There is no difference in rate of readmission or recurrent torsion between surgical approaches, and the overall rate of retorsion is lower than previously reported.
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Affiliation(s)
- Rebecca A Saberi
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida.
| | - Gareth P Gilna
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Cindy Rodriguez
- Florida State University College of Medicine, Tallahassee, Florida
| | - Hallie J Quiroz
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Eva M Urrechaga
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Alessia C Cioci
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Joshua P Parreco
- Division of Trauma and Surgical Critical Care, Memorial Regional Hospital, Hollywood, Florida
| | - Chad M Thorson
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Juan E Sola
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Eduardo A Perez
- DeWitt Daughtry Family Department of Surgery, Division of Pediatric Surgery, University of Miami Miller School of Medicine, Miami, Florida
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