Tasset Julia, Rosen Monica Woll, Bell Sara, Smith Yolanda Regina, Quint Elisabeth H
Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan; Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
J Pediatr Adolesc Gynecol. 2019 Jun;32(3):254-258. doi: 10.1016/j.jpag.2018.10.003. Epub 2018 Oct 25.
To investigate characteristics that differentiate premenarchal girls with ovarian torsion (OT) from those without OT at the time of surgery.
Retrospective chart review of 36 premenarchal girls who underwent 42 surgeries for either OT (n = 33) or a nontorsed ovarian mass (n = 9) from 2006 to 2017.
Large, tertiary care academic institution.
We included patients aged 0-12 years with International Classification of Diseases, Ninth Revision codes for torsion of the ovary, adnexa, ovarian pedicle, or fallopian tube. Controls had International Classification of Diseases, Ninth Revision codes for ovarian mass or cyst, who also underwent surgery and did not have OT.
Records were reviewed for patient characteristics including laboratory and imaging studies, surgical intervention, and pathologic diagnosis. Fischer exact test and the nonparametric Mann-Whitney U test were used for statistical analysis.
Characteristics predictive of OT in premenarchal girls.
Twenty-nine premenarchal patients were diagnosed with 33 episodes of OT. Nine patients underwent surgery for ovarian masses but did not have OT. All patients with OT reported abdominal pain (compared with 55.6% without OT; P < .001) and most had nausea and/or emesis (81.8% vs 33.3%; P < .009). Ultrasound findings of ovarian enlargement and decreased Doppler flow were significant in the OT group (P < .083, P < .009). There were 2 cases of malignancy in each group.
Patients with OT had significantly more nausea, emesis, and abdominal pain compared with those without OT. Additionally, 2 of 4 malignancies were found in patients with OT, indicating that malignancy should still be considered with large, complex masses.
调查在手术时区分初潮前卵巢扭转（OT）女孩与无OT女孩的特征。
对2006年至2017年期间接受42次手术的36名初潮前女孩进行回顾性病历审查，这些手术包括OT（n = 33）或非扭转性卵巢肿块（n = 9）。
大型三级医疗学术机构。
我们纳入了年龄在0至12岁、国际疾病分类第九版中卵巢、附件、卵巢蒂或输卵管扭转编码的患者。对照组为国际疾病分类第九版中卵巢肿块或囊肿编码、也接受了手术且无OT的患者。
审查记录中的患者特征，包括实验室和影像学检查、手术干预及病理诊断。采用Fisher精确检验和非参数Mann-Whitney U检验进行统计分析。
初潮前女孩中OT的预测特征。
29名初潮前患者被诊断为33次OT发作。9名患者因卵巢肿块接受手术但无OT。所有OT患者均报告腹痛（无OT患者为55.6%；P <.001），大多数有恶心和/或呕吐（81.8%对33.3%；P <.009）。OT组卵巢增大和多普勒血流减少的超声表现具有显著性（P <.083，P <.009）。每组各有2例恶性肿瘤。
与无OT患者相比，OT患者的恶心、呕吐和腹痛明显更多。此外，OT患者中发现4例恶性肿瘤中的2例，表明对于大的复杂肿块仍应考虑恶性肿瘤的可能。
