Clinical indices and histological changes over time in ovarian torsion related to ovarian tumors

In some emergency surgeries for ovarian torsion, the ovary cannot be conserved because of necrosis. Ovarian necrosis and the time from the onset of symptoms to surgery are likely to be directly correlated. In this study, we retrospectively evaluated the clinical indices from the time of onset of acute abdomen to surgery at our hospital, in patients with tumor-related ovarian torsion. Among cases diagnosed preoperatively with benign ovarian tumors between 1995 and 2010, there were 54 patients who developed acute abdomen that was surgically diagnosed as ovarian torsion. For evaluation, these patients were divided into two groups according to the time from the onset of acute abdomen to surgical intervention as follows: <10 and ≥10 h. C-reactive protein (CRP) levels, leukocyte counts, body temperature, tumor size, and degree of torsion were compared between the two patient groups. Ovarian status based on postoperative histopathology was classified as necrotic, congestive, or normal, and was also evaluated. The mean CRP level was significantly higher in the ≥10-h patient group than in the patients undergoing surgery in <10 h. No differences were observed between the two groups for leukocyte counts, body temperature, tumor size, and mean degree of torsion. Ovarian necrosis was only observed only in patients undergoing surgery at ≥10 h. When tumor-related ovarian torsion is suspected, surgery should be performed within 10 h after the onset of acute abdomen to conserve ovarian function.