Keywords
General surgery
Pregnancy
Ultrasonography
Adnexal torsion
Laparotomy
First trimester
How to Cite
Abstract
The use of ultrasound during pregnancy has increased the detection of adnexal masses (with incidences ranging from less than 1% to 25% of pregnancies), of which 72% to 96% resolve spontaneously; only 1% to 3% of masses removed during pregnancy are malignant. One of the most significant complications is ovarian torsion associated with adnexal masses; up to 7% of cases occur in the first trimester and require urgent surgery. The laparoscopic approach is preferred due to its postoperative advantages; however, laparotomy remains a viable and safe option when minimally invasive surgery cannot be performed. This case illustrates the safety of open surgery in a patient with torsion of an adnexal mass during the first trimester of pregnancy at the General Hospital of Cancún “Dr. Jesús Kumate Rodríguez.”. A 21-year-old patient with a 10.6-week pregnancy presented with sudden, severe abdominal pain and signs of peritoneal irritation. Ultrasound revealed an adnexal mass measuring 130 × 93 × 122 mm (O-RADS 4). A laparotomy was performed, during which adnexal torsion was identified; a right salpingo-oophorectomy was carried out. Fetal heart rate was documented as normal 48 hours after surgery. It is concluded that, in the first trimester, laparotomy represents a viable alternative in cases of suspected adnexal torsion due to its low risk of pregnancy loss. However, although laparoscopy is the preferred approach, it is not available in all hospitals.
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