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Torsion of the appendages of the uterus
Last reviewed: 23.04.2024
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Torsion of the appendages includes torsion of the ovary and sometimes the fallopian tube, which can lead to disturbance of the arterial blood supply and the development of ischemia. Torsion of the appendages is a rare pathology, but is most common in women of reproductive age. This disease usually acts as an indicator of the pathology of the ovaries.
What causes the torsion of the appendages?
Risk factors are pregnancy, induction of ovulation, an ovary increase of more than 4 cm (for example, in benign tumors or in hyperstimulation with drugs for induction of ovulation). Torsion of normal appendages is rare, but more often in children than in adults.
Symptoms of torsion of appendages
Torsion of the appendages is characterized by the appearance of sudden severe pain in the lower abdomen, sometimes with nausea and vomiting. For many days, and sometimes weeks before sudden pain, intermittent fever may occur, as well as a colicky abdominal pain that spontaneously passes. An increase in soreness during movement of the cervix can be determined, palpable one-sided swelling in the appendages and peritoneal symptoms.
Diagnosis of torsion of appendages
Torsion of the appendages can be suspected on the basis of typical symptoms and unexplained peritoneal symptoms, with increased pain during movement of the cervix, as well as palpation of the tumor of the uterine appendages without signs of an inflammatory process of the pelvic organs. The diagnosis can be confirmed using color transvaginal Doppler ultrasonography. When the diagnosis is confirmed, immediate laparoscopy or laparotomy is performed.
[Treatment of torsion of appendages
Treatment of torsion of the appendages is to preserve the ovary and the fallopian tube by untwisting them with laparoscopy or laparotomy. Salpingo-oophorectomy is performed in the presence of non-viable tissue, which, perhaps, has not yet been necrotic.