ABSTRACT
Objective: to highlight and suggest a strategy in the management of adnexal torsion in pre- and post- menarcheal adolescent girls
Material and Methods: a retrospective 1 O year chart review was carried out between the period January 2002 and December 2011 at King Khal id University Teaching Hospital [KKUH], Riyadh, a tertiary care center
Results: a total of 71 girls were admitted with post-operative diagnosis of ovarian cyst. Of them, 10 girls had adnexal torsion and underwent oophorectomy; the mean age of the 10 girls was 14.1 [range 8-19] years. The commonest clinical symptom was lower abdominal pain in 9 out of 10 girls. Only 7 out of 10 patients had adnexal tor ion. Other 3 had suspected acute appendicitis. The clinical presentation in general was not specific. The mean time lags between the onset of symptoms and diagnosis was 2.6 +/- 1.3 days [range 1-5 days]. The mean time from diagnosis to surgery was 22.9 +/- 13.6 hours [range 6 -48 hours]. Two girls had normal appearing adnexa while two had benign neoplasm
Conclusion: the evidence from the literature supports conservative laparoscopic management of adnexal torsion with a view of conserving the ovary. Unfortunately, all cases in our study were managed with removal of the adnexa and more than half via laparotomy