Surgical management of adnexal torsion in children and adolescents: Update and review of the literature

This article aims to systematically illustrate the most relevant approach to follow in cases of suspected adnexal torsion in adolescents. We based our evaluation of the role of clinical features, laboratory tests and imaging on recent literature (2013-2015), till we consider the most appropriate surgical treatment which has been reached during our experience. Particularly, this study proves - through the literature review and the evaluation of a record of cases - that conservative treatment is to date the most highly recommended surgical approach for adnexal torsion. To assess the state of ovarian tissue and proceed with the most adequate surgical approach, an intraoperative frozen section analysis may be helpful in selected cases. Recent experimental studies have focused on the consequences of detorsion, which may cause ischemia-reperfusion damage and have speculated about the role of different drugs for its avoidance. Copyright © 2015 CIC Edizioni Internazionali. Roma.