Meynol F, Steyaert H, Valla J S
Service de chirurgie pédiatrique, Fondation Lenval pour Enfants, Nice, France.
Arch Pediatr. 1997 May;4(5):416-9. doi: 10.1016/s0929-693x(97)86664-x.
Experience with adnexa torsion in children, a rare but potentially severe pathology, is still disappointing despite constant radiological progress.
The files of 19 patients with adnexial torsion treated between 1985 and 1995 were retrospectively reviewed and compared to those reported.
Eight adnexectomies, six oophorectomies, five detorsions with cystectomy and one salpingectomy were performed. There were only five salvaged adnexa in this series. Three tumors were found; all other cases, except three, were torsions induced by voluminous functional cysts.
Clinical context (sudden right pelvic pain without fever) seems important to note. Sonographic examination is first necessary, but its results are not accurate enough to confirm the torsion. Endo-rectal ultrasonography should become the best diagnostic method in cases of complicated ovaries. In order to increase the percentage of salvaged adnexa, the authors recommend a laparoscopic approach in emergency when clinical examination was doubtful.
儿童附件扭转是一种罕见但可能严重的病症，尽管放射学不断进步，但治疗经验仍不尽人意。
回顾性分析1985年至1995年间接受治疗的19例附件扭转患者的病历，并与已报道的病例进行比较。
进行了8例附件切除术、6例卵巢切除术、5例扭转复位加囊肿切除术和1例输卵管切除术。本系列中仅5例附件得以保留。发现3例肿瘤；除3例之外，所有其他病例均由大量功能性囊肿引起扭转。
临床情况（突发右下腹疼痛且无发热）似乎值得注意。超声检查是首先必要的，但其结果不足以准确确诊扭转。对于复杂卵巢病例，直肠内超声检查应成为最佳诊断方法。为了提高附件保留率，作者建议在临床检查存疑时，紧急情况下采用腹腔镜手术方法。
