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Oophoropexy for recurrent adnexal torsion complicated by uteroovarian ligament rupture
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Oophoropexy for recurrent adnexal torsion complicated by uteroovarian ligament rupture Sassi Boughizane, MD; Badra Bannour, MD; Imen Bannour, MD
FIGURE 1
FIGURE 2
Torsion of the right adnexum
Uteroovarian ligament rupture after oophoropexy (white arrow indicates ruptured uteroovarian ligament)
Boughizane. Oophoropexy for recurrent adnexal torsion complicated by uteroovarian ligament rupture. Am J Obstet Gynecol 2019. Boughizane. Oophoropexy for recurrent adnexal torsion complicated by uteroovarian ligament rupture. Am J Obstet Gynecol 2019.
A
29-year-old woman consulted for pelvic pain with vomiting. Her temperature was 37.8 C. Physical examination revealed findings of an acute abdomen. There were no abnormalities on pelvic ultrasound. She underwent diagnostic laparoscopy with the presumptive diagnosis of torsion of the right adnexum. Surgical exploration confirmed the torsion of a normal right adnexum. The adnexum was detorsioned and the woman was discharged from the hospital 24 hours following her operation. Four months later she reconsulted for pelvic pain, and surgical exploration found a recurrent ipsilateral adnexum torsion. The surgeon detorsioned the adnexum and then decided to perform an oophoropexy. To shorten the
uteroovarian ligament, its proximal and distal ends were joined by 2 separate 2-0 polyglactin 910 sutures. The patient was hospitalized again 8 months after the second surgery because of recurrent symptoms. Diagnostic laparoscopy confirmed recurrent torsion of the right adnexum (Figure 1). Detorsion of the adnexum revealed a uteroovarian ligament rupture (Figure 2 and Video). We propose that common practice of oophoropexy to prevent recurrent adnexal torsion is not without risks, as in this case; it was complicated by uteroovarian ligament rupture and recurrent torsion. -
From the Department of Gynecology and Obstetrics, University Hospital Farhat Hached, and Faculty of Medicine, Ibn Al Jazzar, University of Sousse, Sousse, Tunisia. Received June 17, 2019; revised July 11, 2019; accepted Aug. 17, 2019. The authors report no conflict of interest. 0002-9378/$36.00 ª 2019 Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.ajog.2019.08.032
Click Video under article title in Contents at
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2019 American Journal of Obstetrics & Gynecology
1
ajog.org
Oophoropexy for recurrent adnexal torsion complicated by uteroovarian ligament rupture Sassi Boughizane, MD; Badra Bannour, MD; Imen Bannour, MD
FIGURE 1
FIGURE 2
Torsion of the right adnexum
Uteroovarian ligament rupture after oophoropexy (white arrow indicates ruptured uteroovarian ligament)
Boughizane. Oophoropexy for recurrent adnexal torsion complicated by uteroovarian ligament rupture. Am J Obstet Gynecol 2019. Boughizane. Oophoropexy for recurrent adnexal torsion complicated by uteroovarian ligament rupture. Am J Obstet Gynecol 2019.
A
29-year-old woman consulted for pelvic pain with vomiting. Her temperature was 37.8 C. Physical examination revealed findings of an acute abdomen. There were no abnormalities on pelvic ultrasound. She underwent diagnostic laparoscopy with the presumptive diagnosis of torsion of the right adnexum. Surgical exploration confirmed the torsion of a normal right adnexum. The adnexum was detorsioned and the woman was discharged from the hospital 24 hours following her operation. Four months later she reconsulted for pelvic pain, and surgical exploration found a recurrent ipsilateral adnexum torsion. The surgeon detorsioned the adnexum and then decided to perform an oophoropexy. To shorten the
uteroovarian ligament, its proximal and distal ends were joined by 2 separate 2-0 polyglactin 910 sutures. The patient was hospitalized again 8 months after the second surgery because of recurrent symptoms. Diagnostic laparoscopy confirmed recurrent torsion of the right adnexum (Figure 1). Detorsion of the adnexum revealed a uteroovarian ligament rupture (Figure 2 and Video). We propose that common practice of oophoropexy to prevent recurrent adnexal torsion is not without risks, as in this case; it was complicated by uteroovarian ligament rupture and recurrent torsion. -
From the Department of Gynecology and Obstetrics, University Hospital Farhat Hached, and Faculty of Medicine, Ibn Al Jazzar, University of Sousse, Sousse, Tunisia. Received June 17, 2019; revised July 11, 2019; accepted Aug. 17, 2019. The authors report no conflict of interest. 0002-9378/$36.00 ª 2019 Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.ajog.2019.08.032
Click Video under article title in Contents at
-
2019 American Journal of Obstetrics & Gynecology
1