Retrospective analysis of 14 patients who managed for adnexal torsion during pregnancy

Mesut Polat, Taylan Şenol, Adnan İncebıyık, Enis Özkaya, İlhan Şanverdi, Evrim Bostancı, Egemen Aydın, Ateş Karateke

Özet

Objective: To assess some clinical characteristics of patients who were treated for adnexal torsion during pregnancy.Methods: Medical records of 14 pregnant women with adnexal torsion who were surgically treated at our hospital between 1st January 2011 to 30th October 2015 were screened. In addition to the demographic features obtained from medical records, presenting complaints, physical examination and ultrasonographic findings, type of surgery, histopathologic findings, route of deliveries and complications were all recorded.Results: Mean age of patients included in the study was 27.8 ± 3.9 years, mean gravidity was 2.8 ± 1.8 and mean gestational age was 14.4 weeks. Most commonly seen complaint was pelvic pain followed by emesis and vomiting. All participants underwent abdominal surgery showing an adnexal mass with a mean volume of 48.4 ± 12.1 cm2. Also all participants underwent Doppler ultrasound assessment showing decreased ovarian blood flow. Among 14 patients, 3 of them were managed by laparoscopy while remaining was treated by laparotomy. Detorsion and cystectomy were performed in 10 patients while detorsion was performed in 3 patients, in 1 patient after detorsion no blood flow was observed therefore salpingo-oophorectomy was performed due to overt necrotic appearance. Most commonly seen histopathologic type was mature cystic teratoma. No operative complication was observed.Conclusion: Adnexal torsion should be kept in mind in pregnant presenting with acute abdominal pain. Early diagnosis and treatment are important for organ preserving surgery.Key words: Pregnancy, adnexal torsion, ultrasonography

Abstract

Objective: In this study, it was aimed to compare the sensitivity of diagnostic tests in patients with a preliminary diagnosis of brucellosis.Methods: We have compared the serological methods, standard tube agglutination test (STA), Coombs Test (CT), Rose Bengal (RBT), and the gel centrifugation test. In patients with a preliminary diagnosis of brucellosis, subjects with a positive test result of RBT has been included in the research and other diagnostic tests STA, CT and Coombs Gel centrifugation tests were performed within the range of same titration.Results: Total 132 patient’s serums were studied. In RBT positive 92 patients’ serums, negative test results were found in 11 with STA, in 9 with CT and in 6 with gel test. While 35 patients were identified to be positive by using Brucella gel test at 1/5120 titer, no positive test results were seen with STA and CT at the same titer. Generally, CT results were one titration below the gel centrifugation test results.Conclusion: In conclusion, RBT and STA were not always adequate to determine the diagnosis of brucellosis. Low titer STA results should be supported by tests such as CT or gel centrifugation and the seroconversion must be monitored. Due to giving fast results, gel centrifugation test can be preferred in diagnosis of Brucellosis.Key words: Brucellosis, gel centrifugation, Coombs test