关键词: 子宫附件疾病, 扭转, 机械性, 青春期, 诊断, 治疗

Abstract: Objective　To investigate the clinical features，diagnosis，treatment，and pathology of adnexal torsion in adolescent patients.Methods　This study involved a total of 32 adolescent patients，aged 10-18 years，who had adnexal torsion and treated in the First Affiliated Hospital of Wenzhou Medical University between January 2006 and October 2016.For each patient，we retrospectively analyzed general information，clinical features，laboratory tests，diagnosis and treatment data.Results　Symptoms mainly presented as abdominal pain，nausea and vomiting.In some cases，there was an increase in white blood cells，neutrophils and tumor biomarkers.Ultrasound and computed tomography（CT） examination revealed a pelvic mass or suggested adnexal torsion.In terms of treatment，30 cases underwent laparoscopic surgery.Of these，12 cases received laparoscopic ipsilateral adnexectomy，10 cases received laparoscopic cyst removal surgery，and 8 cases received laparoscopic ipsilateral salpingectomy.Two cases underwent conventional laparotomy.Postoperative pathology included mature teratoma，ovarian cyst，ovarian crown cyst，and ovarian mucinous cystadenoma.Patients were further divided into a <3 days group and a ≥3 days group based on the interval between the first onset of symptoms and admission.There were no significant differences between the two groups in terms of age，torsional side，incidence of abdominal pain，nausea or vomiting，white blood cell count，neutrophil count，the proportion of patients in whom significant blood flow signals were not detected，length of stay，obvious necrosis and adhesion of the torsion part，torsion turns，the diameter of torsional mass or the duration of operation time（P>0.05，for all parameters）．The preoperative neutrophil/lymphocyte ratio（NLR），and the rate of torsion diagnosis before surgery were higher in the <3 days group compared with the ≥3 days group（P<0.05）．Conclusion　The symptoms and laboratory tests of adolescent adnexal torsion are non-specific.Ultrasound and CT have certain diagnostic value.However，some patients may be misdiagnosed which delays treatment.In suspected cases，extensive examinations should be carried out，along with diagnosis and treatment，as early as possible in order to minimize the negative impact of the disease.

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