Torsion of the uterine appendages in a 12-year-old girl



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Introduction. The uterine appendage torsion (UAT) is an urgent pathology accompanied by a painful abdominal syndrome and requiring urgent diagnostic and therapeutic measures. In childhood, UAT develops mainly due to organic causes and due to the specific location of internal organs in children. The literature data on organ-preserving surgeries in the long-lasting UAT is very controversial and dubious. There are no objective criteria for assessing ovarian viability after detorsion what impacts the selection of surgical intervention tactics - unjustified adnexectomy may be performed.

Clinical case. Girl P., 12 years old, was admitted to the hospital with a clinical picture of long-lasting torsion of the uterus appendages. Right uterine appendages were detorsed. The child was under observation. In two years, laparoscopic appendectomy was performed for chronic appendicitis. When examining pelvic organs, the right ovary was found reduced in size compared to the left one; there were no macroscopically visible changes; single follicles were visualized in it; the fallopian tube was not changed.

Conclusion. A painful sensation before surgery indicates that the uterus appendages are viable; if there is no abdominal pain, necrosis of the ovary and fallopian tube may be suspected. A surgical tactics is chosen on making a comprehensive analysis of clinical and instrumental findings.

作者简介

A. Bebenina

Pirogov Russian National Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0002-8390-822X

Moscow, 117997

俄罗斯联邦

M. Chundokova

Pirogov Russian National Medical University; Filatov Clinical City Children’s Hospital

编辑信件的主要联系方式.
Email: cmadina@yandex.ru
ORCID iD: 0000-0002-5080-4838

Madina А. Chundokova, Dr.Sc.(med), professor at chair of pediatric surgery in the Pirogov Russian National Medical University

Moscow, 117997; Moscow, 123001

俄罗斯联邦

M. Golovanev

Pirogov Russian National Medical University; Filatov Clinical City Children’s Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0002-5512-9894

Moscow, 117997; Moscow, 123001

俄罗斯联邦

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