Kim Rahyeon, Kim Youngjae, Roh Jaesook
Department of Obstetrics and Gynecology, College of Medicine, Hanyang University, Seoul, Korea.
J Paediatr Child Health. 2012 Mar;48(3):E110-2. doi: 10.1111/j.1440-1754.2010.01878.x. Epub 2010 Oct 26.
We report the case of a premenarchal eight-year-old girl with an adnexal torsion accompanied by acute pyelonephritis with vague, non-specific symptoms. In young girls, symptoms may be vague, with patients complaining of non-specific gastro-intestinal problems. Combination with other complications such as pyelonephritis makes the diagnosis of adnexal torsion even more difficult as in the present case. To preserve future reproductive function, early surgical intervention is required. Although the impact on menarchal development of oophorectomy or partial removal of ovarian tissue before menarche remains to be evaluated, timely recognition and treatment of adnexal torsion clearly increases the possibility of retaining the ovary. Therefore, to decrease the time between the onset of symptoms and the identification of patients at risk, sonography should be considered as a first imaging modality for evaluating children with any degree of abdominal pain accompanied by non-specific symptoms.
我们报告了一例初潮前8岁女童，其附件扭转伴急性肾盂肾炎，症状模糊且不具特异性。在年轻女孩中，症状可能不明确，患者常诉说非特异性胃肠道问题。如本病例所示，与肾盂肾炎等其他并发症并存会使附件扭转的诊断更加困难。为保留未来的生殖功能，需要早期手术干预。尽管初潮前卵巢切除术或部分卵巢组织切除对初潮发育的影响仍有待评估，但及时识别和治疗附件扭转显然增加了保留卵巢的可能性。因此，为缩短症状出现至识别高危患者的时间，对于有任何程度腹痛且伴有非特异性症状的儿童，应将超声检查视为评估的首选影像学方法。
