Russian Journal of Pediatric Surgery, Anesthesia and Intensive CareRussian Journal of Pediatric Surgery, Anesthesia and Intensive Care2219-40612587-6554Eco-Vector57510.17816/psaic575Research ArticleTurning of the uterine appendices in childrenOkunevNikolay A.<p>Dr. Sci. (Med.), Professor</p>nicolai.okunev@yandex.ruhttps://orcid.org/0000-0001-8786-6998OkunevaAlexandra I.<p>Cand. Sci. (Med.), senior lecturer</p>toropkinaokuneva@yandex.ruhttps://orcid.org/0000-0002-7182-2197BegoulovaElena G.<p>pediatric gynecologist</p>begaulova@yandex.ruKuptsovaSvetlana V.<p>pediatric gynecologist</p>Svetlkupcova@yandex.ruKotelnikovaAnna V.<p>is a 6<sup>th</sup> year student</p>anna.kotelnikova.96@bk.ruhttps://orcid.org/0000-0003-4644-0944PodshivalovaIrina A.<p>is a 6<sup>th</sup> year student</p>podshivalova.ira_0511@mail.ruhttps://orcid.org/0000-0002-6484-4793N.P. Ogarev Mordovian State University Medical InstituteChildren’s Republican Clinical Hospital2111202010169740901202008092020Copyright © 2020, Okunev N.A., Okuneva A.I., Begoulova E.G., Kuptsova S.V., Kotelnikova A.V., Podshivalova I.A.2020<p><strong>Purpose.</strong> To analyze the clinical picture of the disease, diagnostic criteria and treatment tactics for girls with torsion of the uterus for 20162018 in the Childrens Republican Clinical Hospital in Saransk.</p>
<p><strong>Materials and methods</strong> of the research: the study included 16 girls who were examined and treated at the state budgetary health institution of the Republic of Mordovia, the Saransk Childrens Republican Clinical Hospital.</p>
<p><strong>Results.</strong> The largest number of torsions was found in patients aged 8 to 12 years. In 69% of cases, girls with this pathology lived in the city, 31% in rural areas. In the first 12 hours from the onset of the disease, most patients, namely 9 patients who were worried about nausea, vomiting, fever, pain on the side of the lesion, came to the emergency room. On examination, 5 patients showed a positive symptom of peritoneal irritation, in 2 it was doubtful, and in 6 negative. During the diagnosis, it was revealed that the right appendage is affected more often than the left. The possibility of preserving obviously unviable uterine appendages on the basis of ultrasound and intraoperative data is described, as well as further tactics of conservative management of girls with torsions are presented.</p>
<p><strong>Conclusion.</strong> Removal of the uterine appendages was performed in cases of congenital torsions with necrosis, torsions with anomalies of development and necrosis of the appendages, as well as with a duration of torsion and necrosis of more than 5 days. In other cases, even with severe signs of malnutrition, organ-preserving operations were performed</p>torsionappendagesuterusdetorsiongirlspatientsперекрутпридаткиматкадеторсиядевочкипациентки[Адамян Л.В., Дьяконова Е.Ю., Сибирская Е.В., и др. Хирургическая тактика при перекруте придатков матки у детей // Репродуктивное здоровье детей и подростков. — 2014. — № 4. — С. 35–41. [Adamyan LV, Dyakonova EYu, Sibirskaya EV, et al. Surgical tactics for torsion of uterine appendages in children. Reproduct. the health of children and adolescents. 2014;(4):35-41. (In Russ.)]][Буланов М.Н. Ультразвуковая гинекология: курс лекций в 3-х томах. Том 3. — М.: Видар-М, 2011. [Bulanov MN. Ul’trazvukovaya ginekologiya: kurs lekcij v 3-h tomah. T. 3. Moscow: Vidar-M, 2011. (In Russ)]][Петлах В.И., Коновалов А.К., Константинова И.П., и др. Диагностика и лечение гинекологических заболеваний в практике детского хирурга // Врач. — 2012. — № 1. — С. 3–7. [Petlakh VI, Konovalov AK, Konstantinova IP, et al. Diagnosis and treatment of gynecological diseases in the practice of a pediatric surgeon. Doctor. 2012;(1):3-7. (In Russ.)]][Agarwal P, Agarwal P, Bagdi R, et al. Ovarian preservation in children for adenexal pathology, current trends in laparoscopic management and our experience. J. Indian Assoc. Pediatr. Surg. 2014;19(2):65-69. https://doi.org/10.4103/0971-9261.129594.][Focseneanu MA, Omurtag K, Ratts VS, Merritt DF. The auto-amputeted adnexa: a reviewed findings in a pediatric population. J. Pediatr. Adolesc. Gynecol. 2013;26(6):305-313. https://doi.org/10.1016/j.jpag.2012.08.012.][Чундокова М.А., Коколина В.Ф., Голоденко Н.В., и др. Диагностика и лечение опухолевидных образований яичников у новорожденных // Вопросы современной педиатрии. — 2006. — Т. 5. — № 1. — С. 650. [Chundokova MA, Kokolina VF, Golodenko NV, et al. Diagnosis and treatment of tumor-like formations of the ovaries in newborns. Questions of modern pediatrics. 2006;5(1):650. (In Russ.)]][Адамян Л.В., Богданова Е.А., Глыбина Т.М., Сибирская Е.В. Абдоминальный синдром у детей и подростков вследствие гинекологической патологии. Ошибки диагностики и лечения // Акушерство и гинекология. — 2012. — № 2. — С. 96–101. [Adamyan LV, Bogdanova EA, Glybina TM, Sibirskaya EV. Abdominal syndrome in children and adolescents due to gynecological pathology. Errors of diagnosis and treatment. Obstetrics and gynecology. 2012;2:96-101. (In Russ.)]][Karayalçin R, Ozcan S, Ozyer S, et al. Conservative laparoscopic management of adnexal torsion. J. Tirkish-German Gynecol. Assoc. 2011;12(1):4-8. https://doi.org/10.5152/jtgga.2011.02.][Цыганкова Л.А., Юдин В.Е. Внематочная беременность, принципы хирургической тактики, лечения и реабилитации // Военно-медицинский журнал. — 2009. — Т. 6. — С. 32–39. [Tsygankova LA, Yudin VE. Ectopic pregnancy, the principles of surgical tactics, treatment and rehabilitation. Military Medical Journal. 2009;6;32-39. (In Russ.)] https://doi.org/10.25207/1608-6228-2017-24-4-191-194.][Spinelli C, Buti I, Pucci V, et al. Adnexal torsion in children and adolescents: new trends to conservative surgical. Gynec. Endocrinol. 2013;29(1):54-58. https://doi.org/10.3109/09513590.2012.705377.]