Germain M, Rarick T, Robins E
Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Maryland, USA.
Obstet Gynecol. 1996 Oct;88(4 Pt 2):715-7. doi: 10.1016/0029-7844(96)00096-8.
Ovarian torsion is a serious gynecologic condition that often results in adnexal removal. If recurrent, this can result in castration of young patients. Torsion in the pediatric population is rare, but it presents more management challenges for gynecologists. There are few reports of prophylactic oophoropexy in patients with intermittent torsion.
A patient with a history of left adnexal torsion was treated with salpingo-oophorectomy at age 10. She subsequently presented at age 12 with right lower quadrant pain, and was found to have a 7 x 6 cm right adnexal mass on ultrasound examination. She was diagnosed with ovarian edema secondary to intermittent torsion. At laparoscopy, she was found to have a 3-cm utero-ovarian ligament. She was treated with laparoscopic shortening of the utero-ovarian ligament, and has remained symptom-free for 1 year.
We believe that this is the first reported case of laparoscopic triplication of the utero-ovarian ligament to prevent recurrent torsion. In young patients, this treatment may be a reasonable alternative to oophoropexy as prophylaxis for ovarian torsion.
卵巢扭转是一种严重的妇科疾病，常导致附件切除。如果复发，这可能导致年轻患者的卵巢切除。儿科人群中的扭转很少见，但对妇科医生来说，它带来了更多的管理挑战。关于间歇性扭转患者预防性卵巢固定术的报道很少。
一名有左侧附件扭转病史的患者在10岁时接受了输卵管卵巢切除术。她随后在12岁时出现右下腹疼痛，超声检查发现右侧附件有一个7×6厘米的肿块。她被诊断为间歇性扭转继发卵巢水肿。在腹腔镜检查中，发现她有一条3厘米长的子宫卵巢韧带。她接受了腹腔镜下子宫卵巢韧带缩短术，术后1年一直无症状。
我们认为这是首例报道的腹腔镜下子宫卵巢韧带三重折叠术预防复发性扭转的病例。对于年轻患者，这种治疗方法可能是卵巢固定术预防卵巢扭转的合理替代方案。
