Adnexal torsion in children: The role of family practice physicians and paediatricians

ObjectivesOvarian torsion (OT) is uncommon and is initially presented to paediatricians and family medicine physicians. The aim of this study is to assess the presentation, reasons for delayed diagnoses, outcomes, and recommended modalities for the early diagnosis of OT.MethodsA retrospective study was carried out in children ≤18 years old from January 2004 to December 2013. The data gathered from medical records included age, presenting symptoms, prior treatment for the same symptoms, delays in presentations, past medical history, clinical findings, diagnostic tests performed, diagnoses and treatments.ResultsAlthough the data of 15 patients were collected, only 11 medical records of patients with adnexal torsion were available for complete review. The average age of the participants in this study was 9.9 ± 3.5 years. All patients complained of abdominal pain; whereas 8 (72.7%) patients presented with vomiting. The average duration of symptoms was 39.7 ± 66 h. Each discipline of general practitioners and paediatricians attended four (36.3%) children. The average delay of presentation to the hospital was 52 ± 68.78 h, and the average delay in diagnosis and final surgery after admission to the hospital was 9.1 ± 2.7 h. Ultrasound and Doppler imaging were the only diagnostic tools used for pre-operative diagnoses.ConclusionsWe believe that paediatricians and general practitioners are the first line of physicians to initially assess patients with OT, and they should have a high index of suspicion while managing patients with OT. They should perform early ultrasound and Doppler and refer patients to tertiary care centres where early intervention could save the patients' ovaries and future fertility.