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30.01.2022 | Review

Ovarian torsion: diagnosis, surgery, and fertility preservation in the pediatric population

verfasst von: Alexandra Tielli, Andrea Scala, Marianne Alison, Van Dai Vo Chieu, Nicholas Farkas, Luigi Titomanlio, Léa Lenglart

Erschienen in: European Journal of Pediatrics | Ausgabe 4/2022

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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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Titel: Ovarian torsion: diagnosis, surgery, and fertility preservation in the pediatric population
verfasst von: Alexandra Tielli
Andrea Scala
Marianne Alison
Van Dai Vo Chieu
Nicholas Farkas
Luigi Titomanlio
Léa Lenglart
Publikationsdatum: 30.01.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Pediatrics / Ausgabe 4/2022
Print ISSN: 0340-6199
Elektronische ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-021-04352-0

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