高度な鬱血にもかかわらず捻転解除により卵巣機能が温存された非腫瘍性付属器捻転の2例

抄録

  Although torsion of a normal ovary is rare in young women, preservation of ovarian function is an important treatment goal, especially when the ovary may be affected by severe congestion or necrosis. We report 2 cases in which ovarian torsion with apparent necrosis was successfully treated with laparoscopic detorsion.

Case 1: An 18-year-old woman visited our hospital complaining of acute lower abdominal pain. Laparoscopic surgery was performed for suspected ovarian torsion. The left ovary was enlarged at 6 cm in diameter, with torsion of 360 degrees. Although the affected ovary appeared necrotic with purple discoloration, we only performed detorsion. The rescued ovary was 3 cm in diameter 28 days later, and ovulation was detected 5 months later.

Case 2: A 41-year-old woman was scheduled for in vitro fertilization with embryo transfer. Six days after ovum retrieval, she visited our hospital complaining of acute lower abdominal pain. We performed laparoscopic surgery for suspected ovarian torsion. The left ovary was enlarged, with torsion of 360 degrees. Although the ovary appeared necrotic, we only performed detorsion. The affected ovary returned to normal size 14 days later and ovulation was detected 2 months later.

  These cases suggested that laparoscopic detorsion may be an important option for the treatment of torsion in a normal ovary with necrotic appearance to preserve ovarian function.