Adnexal Torsion in 19th Week of Gestation-Laparoscopic Treatment of a Rare Cause for Acute Abdomen in Second Trimenon of Pregnancy

作者：Hauenstein E^*; Keim S; Beyreuther H J; Anthuber C

来源：Geburtshilfe und Frauenheilkunde, 2010, 70(9): 744-747.

DOI：10.1055/s-0030-1250279

• adnexal torsion
• acute abdomen in pregnancy
• laparoscopy in pregnancy

We report about a 28-year old primigravida with acute abdomen caused by adnexal torsion. In the 14th week of gestation, an adnexal mass of 8 cm diameter was diagnosed in the right lower abdominal quadrant. The patient refused surgical intervention. In the 19th gestational week, conservative treatment with pain medication had failed and laparoscopy was performed.
Adnexal torsion is an important differential diagnosis for acute abdominal pain in second and third trimenon of pregnancy. Surgical intervention in pregnancy is often performed with delay, making preservation of the torqued ovary impossible. Recently, magnet resonance tomography (MRT) has been established as an additional imaging method. Laparoscopy should be performed via the left upper abdominal quadrant. Postoperative complications can include recurrence of torsion, necrosis of a preserved adnex and development of (sub) ileus. Surgical intervention after 23 + 0 weeks of gestation should be performed after respiratory distress prophylaxis has been given. Surgery should only be started after preparations for an emergency cesarean section.

• 出版日期2010-9