Obstetrics & Gynecology

Answer 7 Urgent surgical intervention with laparoscopy and plan to detorse or untwist the ovary and adnexa. Ovarian torsion is a gynecologic emergency. Ideally, the patient should be taken for surgical evaluation as quickly as possible before torsion or compromise of adnexal blood supply leads to tissue necrosis. The appearance of the adnexa and ovary at the time of surgery is generally darkened blue and white with cyanosis. The recommended course of action is laparoscopic management with untorsing and ovarian conservation.7,8 This method has been demonstrated as safe by numerous studies of women with ovarian torsion. Excision of the affected ovary is unnecessary, and ovaries that appear necrotic at the time of surgery will generally remain viable if treated by untwisting in a timely manner.9 REFERENCE 7.  Pansky M, Abargil A, Dreazen E, et al. Conservative management of adnexal torsion in premenarchal girls. J Am Assoc Gynecol Laparosc 2000;7:121-4. 8.  Celik A, Orkan E, Ademir H, et al. Long-term results of conservative management of adnexal torsion in children. J Peds Surgery 2005;40:704-8. 9. Templeman C, Hertweck SP, Fallat ME. The clinical course of unresected ovarian torsion. J Peds Surgery 2000; 35:1385-7. Click here to return to the questions

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