Scheier Eric
Pediatric Emergency Department, Kaplan Medical Center, Rehovot, Israel.
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Open Access Emerg Med. 2022 Jun 23;14:283-291. doi: 10.2147/OAEM.S342725. eCollection 2022.
Ovarian torsion is defined as twisting of the ovary around an axis consisting of its vascular pedicle, the infundibulopelvic ligament and the tubo-ovarian ligament, and can occur in females of any age. Torsion can be a result of ovarian mass causing asymmetry and subsequent torsion, or can be spontaneous. While ovarian torsion is a surgical emergency, early diagnosis and treatment can preserve ovarian viability even if necrosis is seen operatively. Presentation classically involves sudden onset severe abdominal pain and vomiting but diagnostic delay can follow subtler presentations. Diagnosis is most commonly based on sonographic findings, but advanced imaging such as CT or MRI may be required if sonography is not diagnostic. Treatment is surgical, with ovarian preservation preferred in almost all cases. In this review, I present the most recent evidence on epidemiology, diagnosis, and management of pediatric ovarian torsion, with a focus on point-of-care ultrasound for the emergency care provider.
卵巢扭转是指卵巢围绕由其血管蒂、漏斗骨盆韧带和输卵管卵巢韧带组成的轴发生扭转，可发生于任何年龄的女性。扭转可能是卵巢肿物导致不对称继而发生扭转的结果，也可能是自发性的。虽然卵巢扭转是外科急症，但即使术中发现卵巢坏死，早期诊断和治疗仍可保留卵巢的活力。典型表现为突发的严重腹痛和呕吐，但症状较隐匿时可能会出现诊断延迟。诊断最常基于超声检查结果，但如果超声检查不能明确诊断，则可能需要CT或MRI等高级影像学检查。治疗为手术治疗，几乎在所有病例中都优先保留卵巢。在本综述中，我介绍了小儿卵巢扭转在流行病学、诊断和管理方面的最新证据，重点关注为急救人员提供的即时超声检查。
