doiSerbia

Acute abdomen caused by adnexal torsion in the first trimester of pregnancy: A case report

Terzić Milan (Klinika za ginekologiju i akušerstvo, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Akšam Slavica (Klinika za ginekologiju i akušerstvo, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Maričić Sanja (Dom zdravlja „Savski venac”, Beograd)
Arsenović Nebojša (Odeljenje za ćelijsku patologiju, Okružna bolnica, Linkoln, Velika Britanija)

Introduction. Adnexal torsion is a rare cause of acute abdominal pain during pregnancy. The clinical and laboratory findings are non-specific. In this paper we present a case of adnexal torsion in the first trimester of pregnancy. Case Outline. On admission, the patient presented signs of acute abdomen. The pain started few hours prior to admission, and was predominantly localized, occasionally irradiating to the central parts of the lower abdomen, accompanied by nausea and vomiting. Ultrasound revealed viable intrauterine pregnancy and right adnexal mass with small amount of free fluid in the Douglas pouch. After short preoperative evaluation, laparotomy and adnexectomy were performed. Surgery and postoperative follow-up were uneventful, and histopathology reported torquated corpus luteum cysts. Conclusion. The diagnosis of adnexal torsion during pregnancy is difficult, and occasionally remains a diagnostic dilemma. Surgery is inevitable, must be prompt, and comprises adnexectomy.

Keywords: adnexal torsion, pregnancy, first trimester, ultrasound, surgery