Results of diagnosis and treatment of girls with cystic formations and adnexal torsion

The OBJECTIVE was to evaluate the effectiveness of modern diagnostic methods and organ-preserving treatment of girls with cystic formations and adnexal torsion to develop an optimal therapeutic and diagnostic algorithm.

METHODS AND MATERIALS. A retrospective analysis of 81 cases of adnexal torsion in girls aged 8 to 17 years (mean age 13.2±2.4 years) treated from 2017 to 2024 was conducted. Based on the severity of clinical manifestations, three stages of the disease were proposed: stage I – initial manifestations; stage II – severe symptoms; stage III – suspected irreversible ischemic changes in the affected organ.

RESULTS. In 57 (70.4 %) patients, the referral diagnosis was acute appendicitis, and the correct diagnosis at the outpatient stage was established in only 7 (8.6 %) cases. Distribution by severity of clinical manifestations: stage I – 33 (40.7 %), stage II – 28 (34.6 %), stage III – 20 (24.7 %) patients. Ultrasound with color Doppler imaging showed a sensitivity of 75.3%. Intraoperatively, organic causes of torsion were identified in 65 (80.2 %) patients. Laparoscopic approach was used in 61 (75.3 %) patients. Organ-preserving operations were performed in 74 (91.4 %) patients: 100 % in stages I–II and 65 % in stage III. Blood flow restoration after detorsion was observed in 65 % of stage III patients and 86 % of stage II patients.

CONCLUSION. Adnexal torsion in girls is characterized by a high frequency of diagnostic errors. Organ-preserving laparoscopic approach is effective in most cases, including patients with severe ischemic changes. The proposed staging classification allows predicting treatment outcomes.

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