Obstetrics and Gynaecology, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
Obstetrics and Gynaecology, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK.
BMJ Case Rep. 2020 May 12;13(5):e232610. doi: 10.1136/bcr-2019-232610.
A 9-year-old girl attended the emergency department with right-sided abdominal pain and vomiting. Due to history and following examination, an ultrasound was requested which demonstrated a large complex midline mass. The most likely diagnosis was ovarian torsion, for which the patient underwent laparoscopy, detorsion and ovarian cystectomy. Histology revealed a mature cystic teratoma. Although less common than in the adult population, it is important to consider ovarian torsion in children and adolescents. Presentation is usually with pain accompanied by vomiting and fever, although these symptoms are not always present. Current management is organ-sparing, with laparoscopy±cystectomy. We discuss the adaptations for this procedure with regard to the paediatric and adolescent population. Differences in the anatomy and physiology must lead to consideration for alterations in surgical technique and positioning to ensure the safest and best quality care for these young patients.
一位 9 岁女孩因右侧腹痛和呕吐到急诊科就诊。根据病史和体格检查，行超声检查提示中线部位有一巨大复杂肿块。最可能的诊断为卵巢扭转，因此患者行腹腔镜检查、复位和卵巢囊肿切除术。组织学检查显示成熟囊性畸胎瘤。虽然儿童和青少年的发病率低于成人，但重要的是要考虑卵巢扭转。临床表现通常为腹痛伴呕吐和发热，但这些症状并非总是存在。目前的治疗方法是保留器官，行腹腔镜检查+/-囊肿切除术。我们讨论了针对儿科和青少年人群的该手术的调整。解剖结构和生理机能的差异必然需要考虑手术技术和体位的改变，以确保为这些年轻患者提供最安全和最佳的护理。
