OVARIAN LESIONS: A COMMON CAUSE OF EMERGENCY SURGERY Spinelli C (1), Di Giacomo M (1), Bertocchini A (2), Pistolesi F (2), Messineo A (2) (1) Chair of Pediatric and Infantile Surgery, University of Pisa, Italy (2) Department of Pediatric Surgery, Children's Hospital A. Meyer, Florence, Italy Introduction: The purpose of this study was to evaluate the clinical presentation and the surgical procedures of ovarian lesions in a large group of girls. Materials and Methods: The medical records of all girls with ovarian lesions admitted to 2 pediatric centers over a 9-year period were reviewed. Presenting symptoms, diagnostic studies, surgical procedure and pathological findings were analyzed. Results: A total of 104 pediatric patients with 111 ovarian lesions(7 girls presented bilateral pathology)were reviewed. The average age was 13,7 years(range: 3 months - 18 years).The most common presenting symptom was abdominal pain(73 cases-65,7%). All girls underwent trans-abdominal US; in 29(26,1%), trans-vaginal US was also performed. Twenty-three(20,7%)required abdominal CT or MRI. Laparoscopy was used in 40(36%); conservative, open or mini-invasive, surgery was possible in 48 cases(43,2%).Pathology showed non neoplastic lesions in 60(54%), follicular cysts(FC)in 33 and hemorrhagic corpus luteum cyst(HCLC)in 27; benign tumors were 47(42,3%)while 5 cases were malignant(4,5%). Twenty cases(18,1%)were treated in emergency; we found 8 HCLC and 7 FC, 3 teratomas and 2 twisted normal ovaries. All patients, except one with yolk-sac tumor, are alive and disease-free. Conclusions: Our experience confirms that often pediatric ovarian lesions present with complications (torsion or rupture)requiring treatment in emergency and extensive surgery. This is the reason why they need to be suspected in any girl who presents abdominal pain, a pelvic or abdominal mass or gynecological endocrine disorders so to allow, whenever possible, conservative surgery to minimize the risk of decreased fertility.
|Autori:||SPINELLI C; Di Giacomo M; Bertocchini; Pistlolesi F; Mucci N; Messineo A|
|Titolo:||Pediatric ovarian lesions a common cause of emergency surgery|
|Anno del prodotto:||2009|
|Appare nelle tipologie:||1.1 Articolo in rivista|