Learning objectives
To review the most common urgent gynecological pathology that we can find in girls between 0 and 16 years old.
To analyze the pathological findings on ultrasound and if it is needed to complete the study later with MR or CT.
To know the differential diagnosis of hypogastric pain in girls.
Background
It is not unusual to find girls sent to our service for acute hypogastric pain with the suspicion of gastrointestinal or urinary pathology,
observing in the ultrasound study that the cause of the pain is ofgynecological origin.
The radiologist must know the differential diagnosis of the most frequent abdominal pathologies by age groups and know to recognize the radiologicalfindings of the acute gynecological pathology. Fig. 11
Transabdominal ultrasonography (US) is the initial imaging modality of choice in children and adolescents with acute or subacute pelvic...
Findings and procedure details
1.
OVARIAN TORSION
Ovarian torsion is defined as partial or complete rotation of the ovarian vascular pedicle causing obstruction to venous outflow and arterial inflow.When fallopian tube also twists with the ovary,
it is known as adnexal torsion.Torsion of the ovarian blood supply will result in venous congestion,
hemorrhage,
and eventually ischemia.
Prolonged ischemia of the ovary or other adnexal structures can lead to necrosis,
resulting in loss of ovarian function or infection and peritonitis.
Torsion is reportedly more common on the right side (3:2)....
Conclusion
The pelvic abdominal pain in girls represents a diagnostic dilemma,
since the signs and symptoms are nonspecific.
The imaging techniques constitute a fundamental tool for its diagnosis,
and the radiologist must know the indications and limitations of the same.
Although acute gynecological pathology is not as frequent as other pathologies,
we must take it into account in the differential diagnosis of abdominal pain in girls.
Personal information
Ana Belén Barba Arce
University Hospital " Marqués de Valdecilla"
Department of Radiology
Avd.
valdecilla s/n .
39008.
Santander.
Spain
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