Adnexal Torsion in Adolescents – a Retrospective Analysis from a Tertiary Centre in Latvia

Jelizaveta Gurmane, Lasma Lidaka


Objective - To review the data of cases of adnexal torsion in the paediatric population in a national level centre in Latvia and examine the pitfalls of diagnostic and therapeutic strategies.

Methods - A retrospective review of medical records was performed on 61 cases of suspected and/or confirmed adnexal torsion in a national level paediatric centre.

Results - In 85.5% of cases the initial diagnosis was made correctly. The age of the patient was a significant contributor to a shorter time until surgery (P=0.016). Abdominal pain was the most common symptom (90.6%), followed by nausea (58.5%) and vomiting (52.8%). Only 62.3% of the torsion patients had an elevated WBC and 69.4% had no elevated body temperature. The shorter the duration of symptoms, the more likely it was that the organ salvage procedure was performed (P=0.021). The sensitivity of ultrasound for the correct diagnosis was 71.4%. In almost a third of the torsion cases, no pelvic lesion was detected on ultrasound (26.5%). When ultrasound suspected torsion, the time before operation was significantly shorter (P<0.001), the presence of blood flow in the ovary extended the time until surgery (P=0.026). Organ-sparing surgery was performed in 73.6% of the cases.

Conclusion - Medical professionals should not exclude the diagnosis of adnexal torsion in the absence of fever or leucocytosis, as well as in the case of normal adnexa on ultrasound. A delay in surgery increases the risk of irreversible ischemic damage leading to organ loss.


Adnexal Torsion; Adolescent; Paediatrics; Adnexal Diseases; Surgery

Full Text:




  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

The full text of articles published in this journal can be used free of charge for personal and educational purposes while respecting authors and publishers' copyrights. For commercial purposes no part of this journal may be reproduced without the written permission of the publisher.