Is It Ovarian Torsion? A Systematic Literature Review and Evaluation of Prediction Signs.

Objectives: This study aimed to identify, through systematic literature review, the most reliable clinical, biological, and radiological signs of ovarian torsion in the pediatric population and to compare their diagnostic value.Methods: This is a systematic review of the literature, searching MEDLIN...

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Publicado en:Pediatric Emergency Care Vol. 32; no. 4; pp. 256 - 262
Autores principales: Rey-Bellet Gasser, Celine, Gehri, Mario, Joseph, Jean-Marc, Pauchard, Jean-Yves
Formato: research systematic review Journal Article
Publicado: Lippincott Williams & Wilkins Apr2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2016
      vid: 32
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Is It Ovarian Torsion? A Systematic Literature Review and Evaluation of Prediction Signs.
      aug:
        au:
          Rey-Bellet Gasser, Celine
          Gehri, Mario
          Joseph, Jean-Marc
          Pauchard, Jean-Yves
        affil: From the Divisions of *Pediatric Emergency Medicine, †Pediatric Medicine, and ‡Pediatric Surgery, Department of Pediatrics, Children's Hospital, Lausanne, Switzerland
      sug:
        subj:
          Ovarian Diseases Diagnosis
          Torsion Abnormality Diagnosis
          Child
          Abdominal Pain Etiology
          Human
          Infant, Newborn
          Infant
          Torsion Abnormality Therapy
          Child, Preschool
          Disease Management
          Ovarian Diseases Therapy
          Adolescence
          Female
          Systematic Review
          Child: 6-12 years
          Infant, Newborn: birth-1 month
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Adolescent: 13-18 years
          Female
      ab: Objectives: This study aimed to identify, through systematic literature review, the most reliable clinical, biological, and radiological signs of ovarian torsion in the pediatric population and to compare their diagnostic value.Methods: This is a systematic review of the literature, searching MEDLINE, EMBASE, and Cochrane Databases for articles published between January 1990 and January 2014.Results: From the 946 references initially identified, 14 retrospective publications fulfilled the inclusion criteria, involving a total of 663 episodes of ovarian torsion. Sudden onset abdominal pain with nausea and/or vomiting is the most frequent symptom of ovarian torsion. It can occur at any age, not only in menarchal or perimenarchal patients. Abdominal tenderness is present in 88.4% of patients, whereas only 24% have a palpable mass. Blood tests are commonly requested (51.4% of cases) but are not diagnostic. Abnormalities on plain abdominal radiograph include masses, calcifications, and ossified images. Ultrasound has a sensitivity for ovarian torsion of 79% and computerized tomographic scan of 42.2%. There is a significant diagnostic delay at 101.8 hours (median).Conclusions: Abdominal pain in children and adolescents is difficult to evaluate, and the diagnosis of ovarian torsion remains a challenge. Because of its potential complications, we need effective clinical tools. From our review of the literature, it was not possible to develop a diagnostic algorithm. Further research is needed to improve our practice and shorten the delay to diagnosis. Considering the low incidence of ovarian torsion, a multicenter prospective study would be required.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        Journal Article
      ougenre: Article
    language: English
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