Abdominal pain syndrome in girls, adolescents and young women with tumor-like formations of the uterine adnexa
Keywordsovarian cyst, uterine adnexаl torsion, girls, adolescents, young reproductive age, laparoscopy
The article presents the clinical features of the complicated course of tumor-like formations of the uterine adnexa in girls, adolescents and young women. The characteristic symptoms of adnexal torsion are described. Topographic and anatomic features leading to torsion of ovarian cysts and uterine appendages, features of the surgical treatment of patients with complicated adnexal torsion are presented.
The aim was to study the frequency of occurrence of ovarian tumor-like formations and their complicated course in girls, adolescents and young women, improve early diagnosis and develop optimal methods of conserving surgical treatment of this pathology.
Material and methods. The study included 90 girls, adolescents and young women. Patients were divided into three groups. 1 group included 30 young women; the 2nd group consisted of 35 adolescents 13-17 years; 3 group consisted of 25 girls from 2 to 12 years. Diagnostic complex included clinical, special gynecological, comprehensive laboratory, ultrasound (including doppler ultrasound) research, computer and magnetic resonance imaging (if indicated).
Results and discussion. The final diagnosis of “Ovarian cyst” was verified in 46 of 90 patients (51,1 %): group 1 – 26 of 30 (86,6 %), in 2 – 18 of 35 (51,4 %), in 3 - 2 of 25 (8 %). It is established that the torsion of the uterine adnexa was detected in 44 of 90 patients: in 1 group – 13,3% of cases (4 of 30 young women), in 2 group – 48,5 % (17 of 35 adolescents), in 3 group – 92 % (23 of 25 girls). 76 surgeries were performed by laparoscopy with preservation of the ovarian reserve, 12 patients were treated conservatively with final diagnosis “Ovulatory syndrome” and “Retention cyst of the ovary”.
Conclusions. Ovarian cyst as the cause of abdominal pain is significantly more often diagnosed in young reproductive age than in patients of prepubertal and pubertal age. In girls and adolescent girls with symptoms of acute abdomen the torsion of intact uterine adnexa was significantly more common than in adult patients, due to anatomical features of the internal reproductive organs and more a mobile lifestyle inherent in this age group. Optimal treatment of functional ovarian cyst is complex conservative therapy, surgical treatment of ovarian cysts at a young age is conducted under strict indications, treatment of choice is laparoscopy.
Tuchkina I., Gnatenko O., Kiebashvili S. (2016). Рerekrut pridatkov matki kak odna iz prichin abdominalnogo bolevogo sindroma u devochek i devushek [Uterine adnexa torsion as the cause of abdominal pain in girls and young women]. Zbirnyk naukovykh prats Asotsiatsii akusheriv-hinekolohiv Ukrainy - Scientific digest of Association of obstetricians and gynaecologists of Ukraine, vol. 2 (38), pp. 372-376 [in Russian].
Stancovich Z., Sedlecky K., Savic D. et al. (2017). Ovarian preservation from tumors and torsions in girls: prospective diagnostic study. J. Pediatr. Adolesc. Gynecol., vol. 30 (3), pp. 405-412.
Tuchkina I., Paschenko Y., Piontkovskaya O. et al. (2018). Urgent conditions in pediatric and adolescent gynecology. Gynecological Endocrinology the 18th World Congress, Florence, Italy, 239 р.
Tuchkina I.O., Gnatenko O.V. (2016). Sposib viboru likuvalnoyi taktiki dlya molodih zhinok ta divchat-pidlitkiv z simptomami gostrogo zhivota [A method of choosing treatment tactics for young women and adolescent girls with symptoms of acute abdomen]. Patent na korisnu model - Patent for utility model, № u201610730 [in Ukrainian].
Morozova O.G. (2008). Vegetativnye disfunkcii v obshchesomaticheskoj praktike [Vegetative dysfunctions in general somatic practice]. J. Health of Ukraine, vol. 3, pp. 51-52 [in Russian].
Korovin S., Dzyadchik A., Galkina Ya., Sokolov Yu. (2016). Laparoskopicheskie vmeshatelstva u devochek s perekrutami pridatkov matki [Laparoscopic interventions at girls with adnexal torsion]. Rossiyskiy vestnik detskoy khirurgii, anesteziologii i reanimatilogii - Russian Bulletin of Pediatric Surgery, Anesthesiology and Critical Care Medicine, vol. 2, pp. 73–79 [in Russian].
Adamyan L., D’yakonova E., Sibirskaya E. et al. (2014). Hirurgicheskaya taktika pri pere krute pridatkov matki u detey [Surgical tactics at adnexal torsion in children]. Reproduktivnoe zdorov’e detey i podrostkov - Reproductive Health of Children and Adolescents, vol. 4, pp. 35–41 [in Russian].
Yağız B., Karaman A., Erdoрan D. (2019). Management of ovarian tumors and adnexal torsion in children; how to save? J Contemp Med., vol. 9 (2), pp. 140–144.
Kun C., Qing Z., Ningxia S. et al. (2018). Conservative laparoscopic management of adnexal torsion based on a 17-year follow-up experience. J Int Med Res., vol. 46 (4), pp. 1685–1689.
How to Cite
Copyright (c) 2021 I. Tuchkina, M. Tuchkina, S. Kiebashvili
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.The periodical offers access to content in the Open Access system under the Creative Commons non-exclusive license (CC BY-ND 4.0).
Number of views and downloads: 46
Number of citations: 0