{"paper_id":"1b089770-1dbb-454c-a2d2-4e8b8969cecf","body_text":"Abstract\nAdnexal torsion, including the ovary and/or fallopian tube, is one of the most common surgical emergencies of the female reproductive tract. Many ovarian and tubal pathologies can increase the risk for torsion. Endometriosis, in particular, increases this risk through ovarian or tubal endometriomas or reactive adhesive disease. Recommended management of adnexal torsion in adolescents is conservative, involving diagnostic laparoscopy, detorsion, cystectomy, and retention of the adnexa despite non-viable appearance.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nMelcer Y, Maymon R, Pekar-Zlotin M, Pansky M, Smorgick N. Clinical and sonographic predictors of adnexal torsion in pediatric and adolescent patients. J Pediatr Surg. 2018;53(7):1396–8.\nBreech LL, Hillard PJA. Adnexal torsion in pediatric and adolescent girls. Curr Opin Obstet Gynecol. 2005;17(5):483–9.\nMordehai J, Mares AJ, Barki Y, Finaly R, Meizner I. Torsion of uterine adnexa in neonates and children: a report of 20 cases. J Pediatr Surg. 1991;26(10):1195–9.\nCelik A, Ergün O, Aldemir H, Ozcan C, Ozok G, Erdener A, et al. Long-term results of conservative management of adnexal torsion in children. J Pediatr Surg. 2005;40(4):704–8.\nLovallo AC, Gaines BA, Zuckerbraun NS. 116: presentation and outcome of adnexal torsion in pediatric patients: a 15-year retrospective review. Ann Emerg Med. 2008;52(4):S78.\nChen M, Chen CD, Yang YS. Torsion of the previously normal uterine adnexa. Evaluation of the correlation between the pathological changes and the clinical characteristics. Acta Obstet Gynecol Scand. 2001;80(1):58–61.\nHibbard LT. Adnexal torsion. Am J Obstet Gynecol. 1985;152(4):456–61.\nRey-Bellet Gasser C, Gehri M, Joseph J-M, Pauchard J-Y. Is it ovarian torsion? A systematic literature review and evaluation of prediction signs. Pediatr Emerg Care. 2016;32(4):256–61.\nAdeyemi-Fowode O, McCracken KA, Todd NJ. Adnexal torsion. J Pediatr Adolesc Gynecol. 2018;31(4):333–8.\nAdeyemi-Fowode O, Lin EG, Syed F, Sangi-Haghpeykar H, Zhu H, Dietrich JE. Adnexal torsion in children and adolescents: a retrospective review of 245 cases at a single institution. J Pediatr Adolesc Gynecol. 2019;32(1):64–9.\nFrank M, Neeman O, Halperin R, Schneider D, Herman A, Pansky M. Simultaneous bilateral torsion and entanglement of the adnexa. JSLS. 2006;10(4):520–1.\nEckler K, Laufer MR, Perlman SE. Conservative management of bilateral asynchronous adnexal torsion with necrosis in a prepubescent girl. J Pediatr Surg. 2000;35(8):1248–51.\nBeaunoyer M, Chapdelaine J, Bouchard S, Ouimet A. Asynchronous bilateral ovarian torsion. J Pediatr Surg. 2004;39(5):746–9.\nOelsner G, Cohen SB, Soriano D, Admon D, Mashiach S, Carp H. Minimal surgery for the twisted ischaemic adnexa can preserve ovarian function. Hum Reprod. 2003;18(12):2599–602.\nServaes S, Zurakowski D, Laufer MR, Feins N, Chow JS. Sonographic findings of ovarian torsion in children. Pediatr Radiol. 2007;37(5):446–51.\nBoukaidi SA, Delotte J, Steyaert H, Valla JS, Sattonet C, Bouaziz J, et al. Thirteen cases of isolated tubal torsions associated with hydrosalpinx in children and adolescents, proposal for conservative management: retrospective review and literature survey. J Pediatr Surg. 2011;46(7):1425–31.\nCass DL. Ovarian torsion. Semin Pediatr Surg. 2005;14(2):86–92.\nDescargues G, Tinlot-Mauger F, Gravier A, Lemoine JP, Marpeau L. Adnexal torsion: a report on forty-five cases. Eur J Obstet Gynecol Reprod Biol. 2001;98(1):91–6.\nAshwal E, Krissi H, Hiersch L, Less S, Eitan R, Peled Y. Presentation, diagnosis, and treatment of ovarian torsion in premenarchal girls. J Pediatr Adolesc Gynecol. 2015;28(6):526–9.\nGaner Herman H, Shalev A, Ginat S, Kerner R, Keidar R, Bar J, et al. Clinical characteristics of adnexal torsion in premenarchal patients. Arch Gynecol Obstet. 2016;293(3):603–8.\nOltmann SC, Fischer A, Barber R, Huang R, Hicks B, Garcia N. Cannot exclude torsion--a 15-year review. J Pediatr Surg. 2009;44(6):1212–6; discussion 1217.\nSmorgick N, Melcer Y, Sarig-Meth T, Maymon R, Vaknin Z, Pansky M. High risk of recurrent torsion in premenarchal girls with torsion of normal adnexa. Fertil Steril. 2016;105(6):1561–1565.e3.\nParazzini F, Esposito G, Tozzi L, Noli S, Bianchi S. Epidemiology of endometriosis and its comorbidities. Eur J Obstet Gynecol Reprod Biol. 2017;209:3–7.\nMissmer SA, Cramer DW. The epidemiology of endometriosis. Obstet Gynecol Clin N Am. 2003;30(1):1–19, vii.\nNgo A-V, Otjen JP, Parisi MT, Ferguson MR, Otto RK, Stanescu AL. Pediatric ovarian torsion: a pictorial review. Pediatr Radiol. 2015;45(12):1845–55; quiz 1842–4\nOzcan C, Celik A, Ozok G, Erdener A, Balik E. Adnexal torsion in children may have a catastrophic sequel: asynchronous bilateral torsion. J Pediatr Surg. 2002;37(11):1617–20.\nGuthrie BD, Adler MD, Powell EC. Incidence and trends of pediatric ovarian torsion hospitalizations in the United States, 2000–2006. Pediatrics. 2010;125(3):532–8.\nHuchon C, Fauconnier A. Adnexal torsion: a literature review. Eur J Obstet Gynecol Reprod Biol. 2010;150(1):8–12.\nPeña JE, Ufberg D, Cooney N, Denis AL. Usefulness of Doppler sonography in the diagnosis of ovarian torsion. Fertil Steril. 2000;73(5):1047–50.\nWarner BW, Kuhn JC, Barr LL. Conservative management of large ovarian cysts in children: the value of serial pelvic ultrasonography. Surgery. 1992;112(4):749–55.\nJenkins S, Olive DL, Haney AF. Endometriosis: pathogenetic implications of the anatomic distribution. Obstet Gynecol. 1986;67(3):335–8.\nWenger JM, Soave I, Lo Monte G, Petignat P, Marci R. Tubal endometrioma within a twisted fallopian tube: a clinically complex diagnosis. J Pediatr Adolesc Gynecol. 2013;26(1):e1–4.\nWang C-J, Go J, Liu Y-C. Isolated tubal torsion with endometriosis. J Minim Invasive Gynecol. 2017;24(4):512–3.\nJames JJ, Powell MC. A case of torsion of a fallopian tube endometrioma. Gynecol Endosc. 1996;5(5):301.\nTurgut A, Dolgun ZN, Acioğlu HÇ, Boran SÜ, Turhan Oİ, Görük NY. Fallopian tube endometrioma with isolated torsion of involved tube. J Obstet Gynaecol. 2013;33(1):96–7.\nPeng T, Parmley TH, Genadry R. Endometriosis and perimenarchal tubal torsion. A case report. J Reprod Med. 1989;34(11):934–6.\nOhara N, Narita F, Murao S. Isolated torsion of haematosalpinx associated with tubal endometriosis. J Obstet Gynaecol. 2003;23(4):453–4.\nSasaki KJ, Miller CE. Adnexal torsion: review of the literature. J Minim Invasive Gynecol. 2014;21(2):196–202.\nKaraman E, Beger B, Çetin O, Melek M, Karaman Y. Ovarian torsion in the normal ovary: a diagnostic challenge in postmenarchal adolescent girls in the emergency department. Med Sci Monit Int. 2017;23:1312–6.\nAppelbaum H, Abraham C, Choi-Rosen J, Ackerman M. Key clinical predictors in the early diagnosis of adnexal torsion in children. J Pediatr Adolesc Gynecol. 2013;26(3):167–70.\nSchmitt ER, Ngai SS, Gausche-Hill M, Renslo R. Twist and shout! Pediatric ovarian torsion clinical update and case discussion. Pediatr Emerg Care. 2013;29(4):518–23; quiz 524–6.\nBronstein ME, Pandya S, Snyder CW, Shi Q, Muensterer OJ. A meta-analysis of B-mode ultrasound, Doppler ultrasound, and computed tomography to diagnose pediatric ovarian torsion. Eur J Pediatr Surg. 2015;25(1):82–6.\nTsafrir Z, Azem F, Hasson J, Solomon E, Almog B, Nagar H, et al. Risk factors, symptoms, and treatment of ovarian torsion in children: the twelve-year experience of one center. J Minim Invasive Gynecol. 2012;19(1):29–33.\nHubner N, Langer JC, Kives S, Allen LM. Evolution in the management of pediatric and adolescent ovarian torsion as a result of quality improvement measures. J Pediatr Adolesc Gynecol. 2017;30(1):132–7.\nRossi BV, Ference EH, Zurakowski D, Scholz S, Feins NR, Chow JS, et al. The clinical presentation and surgical management of adnexal torsion in the pediatric and adolescent population. J Pediatr Adolesc Gynecol. 2012;25(2):109–13.\nLourenco AP, Swenson D, Tubbs RJ, Lazarus E. Ovarian and tubal torsion: imaging findings on US, CT, and MRI. Emerg Radiol. 2014;21(2):179–87.\nYildiz A, Erginel B, Akin M, Karadağ CA, Sever N, Tanik C, et al. A retrospective review of the adnexal outcome after detorsion in premenarchal girls. Afr J Paediatr Surg. 2014;11(4):304–7.\nNaiditch JA, Barsness KA. The positive and negative predictive value of transabdominal color Doppler ultrasound for diagnosing ovarian torsion in pediatric patients. J Pediatr Surg. 2013;48(6):1283–7.\nKives S, Gascon S, Dubuc É, Van Eyk N. No. 341-diagnosis and management of adnexal torsion in children, adolescents, and adults. J Obstet Gynaecol Can. 2017;39(2):82–90.\nGerscovich EO, Corwin MT, Sekhon S, Runner GJ, Gandour-Edwards RF. Sonographic appearance of adnexal torsion, correlation with other imaging modalities, and clinical history. Ultrasound Q. 2014;30(1):49–55.\nChildress KJ, Dietrich JE. Pediatric ovarian torsion. Surg Clin North Am. 2017;97(1):209–21.\nLinam LE, Darolia R, Naffaa LN, Breech LL, O’hara SM, Hillard PJ, et al. US findings of adnexal torsion in children and adolescents: size really does matter. Pediatr Radiol. 2007;37(10):1013–9.\nAlbayram F, Hamper UM. Ovarian and adnexal torsion: spectrum of sonographic findings with pathologic correlation. J Ultrasound Med. 2001;20(10):1083–9.\nRousseau V, Massicot R, Darwish AA, Sauvat F, Emond S, Thibaud E, et al. Emergency management and conservative surgery of ovarian torsion in children: a report of 40 cases. J Pediatr Adolesc Gynecol. 2008;21(4):201–6.\nPoonai N, Poonai C, Lim R, Lynch T. Pediatric ovarian torsion: case series and review of the literature. Can J Surg. 2013;56(2):103–8.\nSchwartz BI, Huppert JS, Chen C, Huang B, Reed JL. Creation of a composite score to predict adnexal torsion in children and adolescents. J Pediatr Adolesc Gynecol. 2018;31(2):132–7.\nPiper HG, Oltmann SC, Xu L, Adusumilli S, Fischer AC. Ovarian torsion: diagnosis of inclusion mandates earlier intervention. J Pediatr Surg. 2012;47(11):2071–6.\nAziz D, Davis V, Allen L, Langer JC. Ovarian torsion in children: is oophorectomy necessary? J Pediatr Surg. 2004;39(5):750–3.\nSpinelli C, Piscioneri J, Strambi S. Adnexal torsion in adolescents: update and review of the literature. Curr Opin Obstet Gynecol. 2015;27(5):320–5.\nSantos XM, Cass DL, Dietrich JE. Outcome following detorsion of torsed adnexa in children. J Pediatr Adolesc Gynecol. 2015;28(3):136–8.\nGeimanaite L, Trainavicius K. Ovarian torsion in children: management and outcomes. J Pediatr Surg. 2013;48(9):1946–53.\nGalinier P, Carfagna L, Delsol M, Ballouhey Q, Lemasson F, Le Mandat A, et al. Ovarian torsion. Management and ovarian prognosis: a report of 45 cases. J Pediatr Surg. 2009;44(9):1759–65.\nLo L-M, Chang S-D, Horng S-G, Yang T-Y, Lee C-L, Liang C-C. Laparoscopy versus laparotomy for surgical intervention of ovarian torsion. J Obstet Gynaecol Res. 2008;34(6):1020–5.\nSola R, Wormer BA, Walters AL, Heniford BT, Schulman AM. National trends in the surgical treatment of ovarian torsion in children: an analysis of 2041 pediatric patients utilizing the nationwide inpatient sample. Am Surg. 2015;81(9):844–8.\nDasgupta R, Renaud E, Goldin AB, Baird R, Cameron DB, Arnold MA, et al. Ovarian torsion in pediatric and adolescent patients: a systematic review. J Pediatr Surg. 2018;53(7):1387–91.\nCampbell BT, Austin DM, Kahn O, McCann MC, Lerer TJ, Lee K, et al. Current trends in the surgical treatment of pediatric ovarian torsion: we can do better. J Pediatr Surg. 2015;50(8):1374–7.\nKokoska ER, Keller MS, Weber TR. Acute ovarian torsion in children. Am J Surg. 2000;180(6):462–5.\nNo PB. 174 summary: evaluation and management of adnexal masses. Obstet Gynecol. 2016;128(5):1193–5.\nAbeş M, Sarihan H. Oophoropexy in children with ovarian torsion. Eur J Pediatr Surg. 2004;14(3):168–71.\nKurtoglu E, Kokcu A, Danaci M. Asynchronous bilateral ovarian torsion. A case report and mini review. J Pediatr Adolesc Gynecol. 2014;27(3):122–4.\nWeitzman VN, DiLuigi AJ, Maier DB, Nulsen JC. Prevention of recurrent adnexal torsion. Fertil Steril. 2008;90(5):2018.e1–3.\nFuchs N, Smorgick N, Tovbin Y, Ben Ami I, Maymon R, Halperin R, et al. Oophoropexy to prevent adnexal torsion: how, when, and for whom? J Minim Invasive Gynecol. 2010;17(2):205–8.\nSheizaf B, Ohana E, Weintraub AY. “Habitual adnexal torsions”–recurrence after two oophoropexies in a prepubertal girl: a case report and review of the literature. J Pediatr Adolesc Gynecol. 2013;26(3):e81–4.\nComeau IM, Hubner N, Kives SL, Allen LM. Rates and technique for oophoropexy in pediatric ovarian torsion: a single-institution case series. J Pediatr Adolesc Gynecol. 2017;30(3):418–21.\nBellati F, Ruscito I, Gasparri ML, Antonilli M, Pernice M, Vallone C, et al. Effects of unilateral ovariectomy on female fertility outcome. Arch Gynecol Obstet. 2014;290(2):349–53.\nParelkar SV, Mundada D, Sanghvi BV, Joshi PB, Oak SN, Kapadnis SP, et al. Should the ovary always be conserved in torsion? A tertiary care institute experience. J Pediatr Surg. 2014;49(3):465–8.\nWang J-H, Wu D-H, Jin H, Wu Y-Z. Predominant etiology of adnexal torsion and ovarian outcome after detorsion in premenarchal girls. Eur J Pediatr Surg. 2010;20(5):298–301.\nWalker SK, Lal DR, Boyd KP, Sato TT. Management of pediatric ovarian torsion: evidence of follicular development after ovarian preservation. Surgery. 2018;163(3):547–52.\nLee SY, Kim M-L, Seong SJ, Bae JW, Cho YJ. Recurrence of ovarian endometrioma in adolescents after conservative, laparoscopic cyst enucleation. J Pediatr Adolesc Gynecol. 2017;30(2):228–33.\nSchindler AE. Non-contraceptive benefits of oral hormonal contraceptives. Int J Endocrinol Metab. 2013;11(1):41–7.\nMaguire K, Westhoff C. The state of hormonal contraception today: established and emerging noncontraceptive health benefits. Am J Obstet Gynecol. 2011;205(4 Suppl):S4–8.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2020 Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nStambough, K.C., Childress, K.J. (2020). Ovarian Torsion in Adolescents. In: Nezhat, C.H. (eds) Endometriosis in Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-030-52984-0_28\nDownload citation\nDOI: https://doi.org/10.1007/978-3-030-52984-0_28\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-030-52983-3\nOnline ISBN: 978-3-030-52984-0\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}