Abstract
Abstract
Background:
Ovarian torsion is a rare gynecologic emergency in adolescents and, upon diagnosis, immediate surgical intervention is mandatory to salvage the affected ovary. Oophorectomy is conventionally performed when the affected ovary is clinically deemed nonviable. However, a recent conservative method of detorsion and conservation of an apparently gangrenous twisted ovarian cyst has emerged, and it has been proven that seemingly gangrenous ovarian tissue is still capable of remaining viable even after prolonged ischemia.
Cases:
This article reports 2 cases of young adolescents, each of whom presented with an acute abdomen secondary to ovarian cyst torsion. Both patients were managed with two-stage conservative laparoscopic surgery (laparoscopic detorsion followed by interval laparoscopic cystectomy) performed by a general gynecologist in a district hospital. Although the twisted ovary appeared gangrenous during the emergency diagnostic laparoscopy in both cases, detorsion rather than conventional oophorectomy was performed.
Results:
In each case, subsequent second-look laparoscopy revealed viable ovarian tissue, enabling conservation of the ovary by only cystectomy, thus salvaging a previously apparent gangrenous ovary. Histopathologic testing confirmed benign ovarian cysts in both cases.
Conclusions:
Laparoscopic detorsion is currently the preferred choice of treatment for a twisted ovary in an adolescent, despite its gangrenous appearance. This is a simple but crucial procedure that can be performed easily by a general gynecologist with level 2 operative laparoscopic skills. Detorsion would be a superior option to maximize female ovarian reserve and future reproductive potential. (J GYNECOL SURG 34:150)
Get full access to this article
View all access options for this article.