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极低龄女童的附件扭转:诊断陷阱

Adnexal torsion in very young girls: diagnostic pitfalls.

作者信息

Emonts Marieke, Doornewaard Heleen, Admiraal J Co'tje F

机构信息

Department of Gynaecology and Obstetrics, Groene Hart Hospital, Post Box 1098, 2800 BB Gouda, The Netherlands.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2004 Oct 15;116(2):207-10. doi: 10.1016/j.ejogrb.2004.01.002.

Abstract

OBJECTIVE

Evaluation of cases of young girls diagnosed with adnexal torsion.

STUDY DESIGN

Retrospective cohort study of 39 girls born between January 1980 and January 2000 who presented with acute abdominal pain and/or the diagnosis adnexal torsion in the Groene Hart Hospital. Seven patients, aged 6-13 years, with adnexal torsion were further evaluated.

RESULTS

In three patients, it was possible to save the adnexa. Only the time relapse between the onset of complaints and the surgical intervention correlated with the presence of microscopic necrosis in the ovary. Bluish-black appearance of an ovary did not correlate with the presence of microscopic necrosis.

CONCLUSIONS

Early recognition and treatment are essential to minimise the risk of decreased fertility after adnexal torsion in young girls. We therefore advocate prompt diagnostic laparoscopy and detorsion of the adnexa. In case a cyst is present, it should not be resected, but checked on a regular basis using ultrasound.

摘要

目的

评估诊断为附件扭转的年轻女孩病例。

研究设计

对1980年1月至2000年1月间出生、在格罗内哈特医院出现急性腹痛和/或诊断为附件扭转的39名女孩进行回顾性队列研究。对7例年龄在6至13岁的附件扭转患者进行了进一步评估。

结果

3例患者成功保留了附件。仅主诉出现至手术干预的时间间隔与卵巢微小坏死的存在相关。卵巢蓝黑色外观与微小坏死的存在无关。

结论

早期识别和治疗对于将年轻女孩附件扭转后生育能力下降的风险降至最低至关重要。因此,我们提倡及时进行诊断性腹腔镜检查并解除附件扭转。如果存在囊肿,不应将其切除,而应定期使用超声检查。

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