CLINICAL AND PATHOLOGICAL EVALUATION OF 50 CASES OF UTERINE ADNEXAL TORSION

Uterine adnexal torsion is a significant cause of acute lower abdominal pain in women. If the torsion is complete and the diagnosis is delayed, it may lead to necrosis, peritonitis and death. Usually the medium-sized, non-adherent masses undergo torsion. Initially the venous and lymphatic circulations are involved and this can lead to oedema, ovarian enlargement and hemorrhage. The ovary can be saved if venous or arterial thrombosis has not occurred. In this study 50 cases of adnexectomy for ovarian adnexal torsion, incurred over 10 years, were studied form patients files in order to find out the pre-existing pathological causes which predisposed adnexal twist. The results showed that the average age was 20 (ranged 16 to 25 years), with a history of sudden and sharp pain in 100 % of cases, accompanied by nausea and vomiting in 72 % of cases, followed by leukocytosis in 66 % and temperature of 38oC and above in 26 % of cases. Benign tumor size ranged from 4 x 6 cm to 25 x 30 cm. In 62 % of cases the right ovary was involved. The pathologic findings included: follicular and corpus luteum cyst (34 %), dermoid (26 %), mucinous cystadenoma (4 %), dysgerminoma (4 %), adenofibroma (2 %) and in 30 % of cases the pathology was not diagnostic due to severe necrosis. The findings from this study conclude that average-sized benign cysts are amenable to adnexal torsion.