Koudelka J, Králová M, Eliás P, Spacek J, Preis J
Oddĕlení dĕtské chirurgie FN, Hradec Králové.
Rozhl Chir. 1994 Dec;73(8):366-70.
During the 7-year period (1987-1993) the authors treated nine girls on account of torsion of the adnexa. In six girls torsion of primarily unaltered adnexa occurred, in one girl torsion of an ovary enlarged by a cyst and in two torsion of the ovary affected with a benign tumour, a coetaneous teratoma. In seven instances the organ affected with ischaemic necrosis had to be resected. In two girls detorsion of the ovary was performed, according to a sonographic control examination, however, in one the affected ovary atrophied. In the discussion the authors deal with the diagnosis of torsion of the adnexa and the method of treatment. The authors consider ultrasonic examination of organs of the abdominal cavity and retroperitoneum a very suitable method in all cases of abdominal pain in childhood, as this method can greatly contribute to the diagnosis of acute abdominal and gynaecological attacks. During surgery they recommend to preserve adnexa with a doubtful vitality because there is certain hope that they will be saved. During the postoperative period they recommend the long-term follow up of girls clinically and by ultrasonographic checks. If pathological changes are detected on the preserved adnexa, they recommend early re-operation and elimination of the risk factor (cysts etc.). The operation should be supplemented by prophylactic fixation of the preserved adnexa if this fixation was not done already during the primary operation.
在1987年至1993年的7年期间,作者治疗了9例附件扭转的女孩。其中6例为原发性未改变附件的扭转,1例为因囊肿而增大的卵巢扭转,2例为受良性肿瘤(同期畸胎瘤)影响的卵巢扭转。7例中,发生缺血性坏死的器官不得不被切除。2例女孩进行了卵巢复位术,根据超声对照检查,然而,其中1例受影响的卵巢萎缩。在讨论中,作者探讨了附件扭转的诊断和治疗方法。作者认为,对于儿童期所有腹痛病例,超声检查腹腔和腹膜后器官是一种非常合适的方法,因为这种方法对急性腹部和妇科急症的诊断有很大帮助。在手术中,他们建议保留活力可疑的附件,因为有一定希望能挽救它们。在术后阶段,他们建议对女孩进行临床和超声检查的长期随访。如果在保留的附件上检测到病理变化,他们建议早期再次手术并消除危险因素(囊肿等)。如果在初次手术时未进行预防性固定,手术应辅以对保留附件的预防性固定。