Management of Bilateral Adnexal Torsion in a Case of Ovarian Hyperstimulation Syndrome
1Department of Obstetrics and Gynecology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
2Department of Obstetrics and Gynecology, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
Eur Arch Med Res 2018; 34(3): 196-199 DOI: 10.5152/eamr.2018.89411
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Abstract

Adnexal torsion (AT) is usually unilateral and traditionally treated by oophorectomy. We present a case of bilateral AT, developed consequent to ovarian hyperstimulation syndrome (OHSS), man-aged by detorsion of the ovaries without oophorectomy. A 27-year-old female patient who under-went in vitro fertilization was hospitalized with acute abdomen. On ultrasonography, multifollicular ovaries, displaying continuity with each other on both sides with a size of 25×12 cm, which are consistent with OHSS and no apparent blood flow in the right adnexal area, were observed. In laparotomy, the right ovary (10×8 cm), left ovary (16×14 cm), and adnexa were bilaterally torsioned. Adnexa was detorsioned. Although it is assumed that blood flow did not improve in the ovaries, considering the patient’s fertility desire, oophorectomy was not performed. On sonography at 6 months, the size of the ovaries and blood flow were normal. Conservative surgery should be the first choice of treatment in AT to preserve fertility in patients who underwent artificial reproductive technologies.