重新思考通过附件扭转反转来保留卵巢：一例延迟诊断。
Rethinking ovary preservation by adnexal torsion reversal in adolescents: a case of delayed diagnosis.
机构信息
Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Dongcheng District, 17 Qihelou Street, Beijing, 100006, China.
出版信息
BMC Womens Health. 2022 Oct 24;22(1):421. doi: 10.1186/s12905-022-02013-4.
BACKGROUND
This article discusses the management of an adolescent woman with a delayed diagnosis of adnexal torsion (AT) whose ovaries were successfully preserved.
CASE PRESENTATION
The patient was a 14-year-old female teen admitted with the chief complaint of lower abdominal pain for 3 days and worsening pain for 2 days. Magnetic resonance imaging suggested a high possibility of torsion in the anterosuperior uterine mass and was accompanied by severe ovarian edema, bleeding, and enlargement. Intraoperatively, the left fallopian tube was characterized by thickening and torsion and appeared blackish purple. The left fallopian tube paraovarian cyst was about 20 cm in size, and the left adnexa was twisted 1080° along the left infundibulopelvic ligament (suspensory ligament of the left ovary). The left ovary appeared blackish purple, with an enlarged diameter of about 10 cm. At the request and with the informed consent of the patient's parents, we preserved the left ovary and removed the left fallopian tube. The results of the endocrine, ultrasound, and tumor marker tests were normal 1 month after surgery. Follicles and blood flow signals seen in ultrasound examinations indirectly proved the successful preservation of the left ovary in the follow-up.
CONCLUSIONS
Our attempt to preserve the ovaries in an adolescent with a delayed diagnosis of AT was successful.
背景
本文讨论了一位青春期女性附件扭转（AT）延迟诊断病例的管理，其卵巢得以成功保留。
病例介绍
患者为 14 岁女性青少年，因下腹疼痛 3 天，加重 2 天就诊。磁共振成像提示前上子宫肿块扭转的可能性很高，同时伴有严重的卵巢水肿、出血和增大。术中，左侧输卵管增厚并扭转，呈黑紫色。左侧输卵管卵巢囊肿约 20cm 大小，左侧附件沿左侧输卵管漏斗韧带（左侧卵巢悬韧带）扭转 1080°。左侧卵巢呈黑紫色，直径约 10cm 增大。应患者及其父母的要求，并在其知情同意下，我们保留了左侧卵巢并切除了左侧输卵管。术后 1 个月，内分泌、超声和肿瘤标志物检查结果正常。超声检查中观察到的卵泡和血流信号间接证明了左侧卵巢在随访中成功保留。
结论
我们尝试对延迟诊断 AT 的青春期女性保留卵巢，获得了成功。
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