Çocuklarda izole tubal torsiyon: Olgu sunumu ve literatür deðerlendirilmesi

Ýzole tubal torsiyonlu (ÝTT) pediatrik ve adölesan popülasyondaki hikaye, klinik yansýma, fiziksel inceleme, laboratuvar bulgularýnýn deðerlendirilmesi ve belirlenmesi ile bu olgularýn cerrahi yönetiminin gözden geçirilmesi için çalýþma gerçekleþtirildi. Hastanemizde Ocak 2000 ile Aralýk 2012 tarihleri arasýnda ÝTT tanýsý ile tedavi edilen tüm olgular geriye dönük olarak incelendi. ÝTT tanýsý fiziksel inceleme, ultrasonografi (USG), renkli Doppler USG ve bilgisayarlý tomografiyi (BT) de içeren radyolojik çalýþmalara dayanýlarak konuldu ve cerrahi giriþim ile doðrulandý. Çalýþma döneminde ÝTT’li üç olgu bulunmaktadýr. Olgularýn ikisi adölesan biri ise yenidoðan dönemindeydi. Ýki olguda sol taraflý ÝTT vardý. Yenidoðan olguda prenatal abdominopelvik kitle tanýsý vardý. ÝTT’li diðer iki olgu semptomlarýn baþlamasýndan üç gün sonra baþvurdu. Bu çalýþmadaki tüm olgular salpenjektomi ile tedavi edildi. Ýzole tubal torsiyon ameliyat öncesi olarak nadiren tanýnýr ve en sýklýkla salpenjektomi ile tedavi edilir. Bu nadir durumun daha iyi tanýnmasý tedavide ilerlemelere yardýmcý olabilir. Adneksiyal torsiyonlardaki over koruyucu yaklaþým gibi, daha erken taný ve mümkünse tubanýn korunmasýný da içeren çabuk cerrah giriþim ile bu olgularýn ileriki dönem üreme potansiyelleri artýrabilir.

Isolated salpingeal torsion in children: a case series and review of the literature

This study was carried out to evaluate and determine the history, clinical presentation, and physical examination and laboratory findings in a pediatric (n=1) and adolescent (n=2) population with isolated tubal torsion (ITT) and to examine its surgical management. A retrospective review of all the cases of ITT treated in our hospital between January 2000 and December 2012 was performed. The diagnosis of ITT was performed by physical examination and radiological studies including ultrasonography (US), color Doppler US, and computed tomography (CT) and confirmed by surgical intervention. There were 3 children with ITT in the study period. Two of the patients were adolescents and one was diagnosed in the neonatal period. Two patients had left-sided ITT. The neonatal patient was diagnosed with abdominopelvic mass antenatally. ITT in the other two children occurred three days after the onset of symptoms. All the patients in this study were treated with salpingectomy. ITT is rarely diagnosed preoperatively, and is treated mostly by salpingectomy. A better recognition of this entity may help to improve the treatment of this rare condition. As advocated for ovarian salvage in adnexal torsions, earlier diagnosis and preservation of the tube, if possible, with prompt surgical intervention may increase the future reproductive potential of these patients.