Sukkong Kanchanok, Sananpanichkul Panya, Teerakidpisan Prasong, Bhamarapravatana Kornkarn, Suwannarurk Komsun
Department of Obstetrics and Gynecology, Prapokklao hospital, Chanthaburi, Thailand. Email:
Asian Pac J Cancer Prev. 2016 Nov 1;17(11):4981-4984. doi: 10.22034/APJCP.2016.17.11.4981.
Background: Adnexal torsion results in ischemia of structures distal to twisted pedicle and acute onset of pain is responsible for about 3% of all gynecologic emergencies. Ovarian torsion classically occurs in a pathological enlarged ovary, as with cancer, but diagnosis remains a challenge. Objective: Our purpose was to evaluate clinical risk factors predictive of torsion with gangrenous adnexa. Material and methods: A retrospective descriptive study and chart review of surgically proven ovarian torsion/adnexal torsion cases at the Obstetrics and Gynecology Department of Prapokklao Hospital, Chanthaburi, Thailand between January 2011 and December 2015 was conducted. Result: Seventy-eight cases were identified. Mean age at presentation was 35.5 years. The average maximum diameter of the ovarian tumors was 10.8 cm. The percentage of gangrenous ovarian cysts in this study was 46.2 (36/78). The precision to determine the pathological site by patient, physician and ultrasonography was 8.5, 24.2 and 83.3 percent, respectively with statistically significant variation. Conclusion: Ovarian/adnexal torsion remains a challenge condition especially in young nulliparous women. Sophisticated investigation does not guarantee ovary preservation. Combining clinical acumen, appropriate tests and detailed consideration may be the best practice at the present time.
附件扭转导致扭转蒂远端结构缺血，急性疼痛发作约占所有妇科急症的3%。卵巢扭转典型地发生在病理性增大的卵巢，如癌症患者，但诊断仍然是一项挑战。目的：我们的目的是评估预测伴有坏疽附件扭转的临床危险因素。材料与方法：对泰国尖竹汶府普拉波克洛医院妇产科2011年1月至2015年12月手术证实的卵巢扭转/附件扭转病例进行回顾性描述性研究和病历审查。结果：共识别出78例病例。就诊时的平均年龄为35.5岁。卵巢肿瘤的平均最大直径为10.8厘米。本研究中坏疽性卵巢囊肿的比例为46.2%（36/78）。患者、医生和超声检查确定病理部位的准确率分别为8.5%、24.2%和83.3%，差异有统计学意义。结论：卵巢/附件扭转仍然是一种具有挑战性的疾病，尤其是在年轻未生育女性中。复杂的检查并不能保证保留卵巢。结合临床敏锐度、适当的检查和详细的考虑可能是目前的最佳做法。
