Abstract

Objective: This study aims to find out the clinical features and outcome of conservative laparoscopic management in adolescent females diagnosed as a case of ovarian torsion with special emphasis on management of blue black gangrenous looking ovaries.

Methodology: It was a retrospective, hospital based, cohort study. Adolescent girls (12-18 years) diagnosed with ovarian torsion were assessed regarding mode of presentation, duration, imaging, laparoscopic findings, management and outcome.

Main Results: Among all patients presenting to this institution with ovarian torsion over a four year time period, 34.14% (N = 14/41) were adolescents. All the girls presented with lower abdominal pain along with vomiting. Duration of symptoms ranged from 1-5 days. There was predilection for right sided ovarian torsion (71.4%, N = 10/14). In all the cases laparoscopic ovarian detorsion was done and ovary was either fixed to posterior aspect of uterus or ovarian ligament to prevent retorsion. Ovaries of 6 girls were gangrenous looking, of which one was premenarchal. All the patients had a satisfactory outcome with normal ovarian follicles at 3 months on follow-up ultrasound scan(done in 12 patients).

Conclusion: Laparoscopic detorsion of the ovaries with or without concurrent cystectomy is the mainstay of treatment in adolescent ovarian torsion. Ovaries should be preserved in all the cases of adolescent ovarian torsion as the return of function have been observed in most of the cases.