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AuthorTabbara, Faysal
AuthorHariri, Moustafa
AuthorHitti, Eveline
Available date2024-04-25T06:20:12Z
Publication Date2024
Publication NamePLoS ONE
ResourceScopus
ISSN19326203
URIhttp://dx.doi.org/10.1371/journal.pone.0297690
URIhttp://hdl.handle.net/10576/54234
AbstractOvarian torsion (OT) is a gynecological emergency that can have diverse clinical presentations makings its diagnosis especially challenging. Few studies exist in the literature describing the clinical presentation as well as the management of OT in the emergency department (ED). This study aims to describe the clinical presentation, physical examination, emergency management, radiographic and intraoperative findings, histopathology reports and the time-to-intervention metrics of OT cases presenting to the emergency room of our tertiary care center. Data was collected by a retrospective chart review of all OT cases that presented to our ED over a period of 1 year. A total of 20 cases were included in the final analysis. The incidence of OT in the ED was 157.4 per 100 000 visits of women in the reproductive age group. All patients were women of reproductive age, with a mean age of 27.3 years. A total of 15 patients (78.9%) presented within 24 hours of symptom onset. The most common presenting symptom was abdominal pain (95%, 19/20) with most localizing to the right lower quadrant (60%, 12/20), followed by nausea and vomiting (90%, 18/20). Almost all patients (95%, 19/20) required opioids for pain management. The majority (80%, 16/20) were diagnosed by ultrasound prior to surgery, whereas (20%, 4/20) went straight to surgery based on a high index of clinical suspicion. Among those who underwent ultrasound, ovarian cyst was present in (75%, 12/16) while (68.9%, 11/16) showed ovarian enlargement and (50%, 8/16) showed abnormal ovarian blood flow. All patients except one patient underwent operative management. Out of the 19 patients who underwent surgery, the majority of patients (94.7%, 18/19) had viable ovaries with the exception of 1 patient (5.3%) who required a salpingo-oophorectomy post ovarian detorsion. A total of 13 cases included histopathologic review of specimens out of which 6 (46.2%) had a mature cystic teratoma. The mean time from door to ultrasonography was 1.4 hours and from door to surgery was 11.4 hours. Our study provides valuable insights into the incidence, clinical presentation, physical examination, emergency management, ultrasonographic and intraoperative findings, histopathology reports as well as the time-to-intervention metrics of OT patients presenting to the ED.
Languageen
PublisherPublic Library of Science
Subjectopiate
abdominal mass
abdominal pain
abdominal tenderness
alcohol consumption
analgesia
Article
cystadenoma
cystectomy
dermoid cyst
echography
emergency ward
female
fever
flank pain
histopathology
human
human tissue
in vitro fertilization
nausea and vomiting
ovary torsion
pain
physical examination
retrospective study
risk factor
salpingectomy
salpingooophorectomy
smoking
teratoma
tertiary care center
vagina bleeding
adult
hospital emergency service
male
research
tertiary care center
Adult
Emergency Service, Hospital
Female
Humans
Male
Ovarian Torsion
Research
Retrospective Studies
Tertiary Care Centers
TitleOvarian torsion: A retrospective case series at a tertiary care center emergency department
TypeArticle
Issue Number3-Mar
Volume Number19
dc.accessType Open Access


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