Torsion d'annexe en cours de grossesse: à propos d'un cas à l'Hôpital Central de Yaoundé, Cameroun

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Abstract

Les kystes ovariens sont dans la majorité des cas asymptomatiques et peuvent être de découverte fortuite lors d'une échographie. Ils ne deviennent symptomatiques que lorsque survient une complication. Nous présentons un cas de torsion d'annexe gauche diagnostiqué à 8 semaines et 4 jours de grossesse. Nous avons réalisé une annexectomie Suivie de l'administration de progestérone retard à la dose 500 mg par jour. L'évolution a été marquée par la survenue d'un avortement au cinquième jour post opératoire. L'analyse anatomopathologique de la masse chirurgicale a conclu à une apoplexie ovarienne. L'ablation chirurgicale du corps jaune au premier trimestre de la grossesse pose le problème du maintien de celle - ci et devrait être présente à l'esprit des praticiens avant toute chirurgie pelvienne pendant cette période.

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Surgical intervention for maternal ovarian torsion in pregnancy.

Shuenn-Dhy Chang, Chih-Feng Yen, Liang-Ming Lo … (2011)

Maternal ovarian torsion in pregnancy is a rare complication. This study was conducted to review the clinical manifestations, and to compare the outcome between laparoscopy and laparotomy in women undergoing surgery for ovarian torsion (OT) during pregnancy. Using the International Classification of Disease, Ninth Revision, and Clinical Modification, we reviewed the clinical records of patients with OT during pregnancy between 1997 and 2008 at a university hospital. Twenty pregnant women were identified with surgically proven OT, 10 in the first trimester, eight in the second, and two in the third. Thirteen (65%) cases were suspected before operation to be adnexal torsion. The most common symptom and sign were pelvic pain (95%) and an adnexal or pelvic mass (95%), followed by nausea and vomiting (65%), elevated white blood cell count >12×10(9)/L (45%), and fever (10%). Most patients in the first trimester (75%) and a minority in the second and third trimesters (37.5%) received management via laparoscopy. Patients undergoing laparoscopy treatment had smaller ovarian masses and a shorter postoperative hospital stay than those receiving laparotomy. None of these patients had significant complications during or after surgery. However, the outcomes of pregnancy varied: 12 (60%) term deliveries, three (15%) preterm deliveries at over 31 gestational weeks, one missed abortion and four elective abortions in the first trimester. The diagnosis of OT during pregnancy is often missed due to nonspecific clinical features and uncommon objective findings. Detorsion only or detorsion plus ancillary procedures via laparoscopy is recommended to treat pregnant women suffering from OT, owing to the advantages of a shorter hospital stay and favorable surgical and pregnancy outcomes. Copyright © 2011. Published by Elsevier B.V.

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Adnexal torsion.

Gabriel Oelsner, David Shashar (2006)

This review provides timely information concerning clinical, surgical, and pathologic findings of adnexal torsion (AT). AT mostly occurs in the child-bearing age group, but is not uncommon in premenarchal girls or postmenopausal women. When AT is suspected, urgent surgical intervention is indicated, and is usually performed by laparoscopy. Incidence of AT is 3.5% of all benign cystic teratomas. Despite the "necrotic" appearance of the twisted ischemic ovary, detorsion is the only procedure which should be performed at surgery. Adnexectomy should be avoided as ovarian function is preserved in 88% to 100% of cases. Awareness and suspicion of the diagnosis of AT is needed in patients who present with lower abdominal pain.

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Successful pregnancy complicated by early and late adnexal torsion after in vitro fertilization.

Beth Rackow, Pasquale Patrizio (2007)

To report a case of unilateral adnexal torsion and subsequent contralateral adnexal torsion after in vitro fertilization. Case report and literature review. Academic fertility center; university hospital. A 28-year-old woman with tubal factor infertility conceived with IVF and experienced mild-to-moderate ovarian hyperstimulation syndrome. Right adnexal torsion occurred at 7 weeks of gestation, and laparoscopic detorsion was performed. Subsequent contralateral adnexal torsion occurred at 19 weeks and was managed with laparotomy and salpingo-oophorectomy. Laparoscopic right adnexal detorsion and laparotomy with salpingo-oophorectomy for left adnexal torsion. Preservation of torsed adnexa and successful pregnancy. Successful pregnancy and birth complicated by two episodes of adnexal torsion after IVF, and viable right adnexa after laparoscopic detorsion. Subsequent contralateral adnexal torsion is a rare complication of IVF and can occur in the second trimester. Data support preservation of the torsed adnexa despite the ovary's appearance.

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Author and article information

Journal

Journal ID (nlm-ta): Pan Afr Med J

Journal ID (iso-abbrev): Pan Afr Med J

Journal ID (publisher-id): PAMJ

Title: The Pan African Medical Journal

Publisher: The African Field Epidemiology Network

ISSN (Electronic): 1937-8688

Publication date (Electronic): 20 January 2014

Publication date Collection: 2014

Volume: 17

Electronic Location Identifier: 39

Affiliations

[1 ]Unité de Gynécologie-Obstétrique de l'Hôpital Central de Yaoundé, Yaoundé, Cameroun

[2 ]Département de Gynécologie-Obstétrique de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Yaoundé, Cameroun

[3 ]Laboratoire d'Anatomie Pathologique de l'Hôpital Central de Yaoundé, Yaoundé, Cameroun

[4 ]Département de Sciences Morphologiques et d'Anatomie Pathologique de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Yaoundé, Cameroun

Author notes

[& ]Corresponding author: Jovanny Tsuala Fouogue, Département de Gynécologie-Obstétrique de la Faculté de Médecine et des Sciences Biomédicales de l'Université de Yaoundé 1, Yaoundé, Cameroun

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Publisher ID: PAMJ-17-39

DOI: 10.11604/pamj.2014.17.39.3006

PMC ID: 4048683

SO-VID: a2bb90b3-6d62-497a-b8c3-b43a5ccfc4a2

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The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Torsion d'annexe en cours de grossesse: à propos d'un cas à l'Hôpital Central de Yaoundé, Cameroun Translated title: Torsion of uterine appendages during pregnancy: report of a case at Yaoundé Central Hospital, Cameroon

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Most cited references 18

Surgical intervention for maternal ovarian torsion in pregnancy.

Adnexal torsion.

Successful pregnancy complicated by early and late adnexal torsion after in vitro fertilization.

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