Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and Management

<h3>Background</h3><p dir="ltr">In Qatar, primary presentation of acute abdominal pain with most women is to the Emergency Department. Adnexal torsion is a rare time limiting surgical emergency with severe reproductive health consequences characterised by such a presentat...

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Main Author: Morounfolu Thompson (17045472) (author)
Other Authors: Sufia Athar (14777830) (author), Rafael Gonzalez Olubunmi Oniya (18507536) (author), Naglaa Mohamed (1378089) (author), Yehia El Khawly (18466100) (author), Kholode Al Maslamani (18507539) (author), Lolwa Al Ansari (18466227) (author)
Published: 2024
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_version_ 1864513514157113344
author Morounfolu Thompson (17045472)
author2 Sufia Athar (14777830)
Rafael Gonzalez Olubunmi Oniya (18507536)
Naglaa Mohamed (1378089)
Yehia El Khawly (18466100)
Kholode Al Maslamani (18507539)
Lolwa Al Ansari (18466227)
author2_role author
author
author
author
author
author
author_facet Morounfolu Thompson (17045472)
Sufia Athar (14777830)
Rafael Gonzalez Olubunmi Oniya (18507536)
Naglaa Mohamed (1378089)
Yehia El Khawly (18466100)
Kholode Al Maslamani (18507539)
Lolwa Al Ansari (18466227)
author_role author
dc.creator.none.fl_str_mv Morounfolu Thompson (17045472)
Sufia Athar (14777830)
Rafael Gonzalez Olubunmi Oniya (18507536)
Naglaa Mohamed (1378089)
Yehia El Khawly (18466100)
Kholode Al Maslamani (18507539)
Lolwa Al Ansari (18466227)
dc.date.none.fl_str_mv 2024-05-26T08:57:03Z
dc.identifier.none.fl_str_mv 10.57945/manara.25709358.v1
dc.relation.none.fl_str_mv https://figshare.com/articles/conference_contribution/Suspected_Adnexal_Torsion_in_Qatar_Symptomatology_Reliability_in_Diagnosis_and_Management/25709358
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Reproductive medicine
Adnexal torsion
Abdominal pain
Ovarian mass
Emergency presentation
Vaginal bleeding
Qatar Health Congress 2023 and the 3rd Qatar Public Health Conference
dc.title.none.fl_str_mv Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and Management
dc.type.none.fl_str_mv Text
Conference contribution
info:eu-repo/semantics/publishedVersion
text
conference object
description <h3>Background</h3><p dir="ltr">In Qatar, primary presentation of acute abdominal pain with most women is to the Emergency Department. Adnexal torsion is a rare time limiting surgical emergency with severe reproductive health consequences characterised by such a presentation, and firm diagnosis requires direct visualization at surgery.1 Accurate, timely diagnosis of adnexal torsion is crucial to predict the need for surgery and prevent complications, however information on signs and symptomatology reliability is limited in the medical literature. There is currently no relevant reported data from Qatar.</p><h3>Methods</h3><p dir="ltr">This study aimed to assess symptomatology reliability in prediction of surgically proven cases of suspected adnexa torsion presenting to Al Wakra Hospital in Qatar. A database review was conducted of all women with suspected adnexal torsion presenting to the Emergency Departments between 1st January 2017 and 31st December 2022. Clinical data were assessed following a literature review. Sensitivity, specificity and predictive estimates were calculated for each parameter with 95% confidence intervals (CI) included. </p><h3>Results</h3><p dir="ltr">Among 58 suspected cases, 39 (67.24%) were subsequently confirmed as adnexal torsion. The predominating symptomatology was: acute abdominal pain associated with vomiting, abdominal guarding, mass, and tenderness (Figure 1). Tachypnoea was absent in all suspected cases (Table 1). Abdominal tenderness had a very high sensitivity, 99.2% (CI 97.6-99.8%) and positive predictive value, 96.0% (CI 95.1-96.8), while the absence of vaginal bleeding showed a high specificity, 100% (CI 82.4-100%).</p><h3>Conclusion</h3><p dir="ltr">Emergency room presentation and triage of cases with suspected adnexal torsion for surgery can be improved using these study findings. The wide confidence intervals in some parameters reflects the wide variation in clinical presentation and current diagnostic uncertainty.3 It is interesting that tachypnoea does not appear to be a feature in our population while abdominal tenderness is a strong predictor especially when linked with absence of vaginal bleeding.</p>
eu_rights_str_mv openAccess
id Manara2_d3db77bde3cbbbcbda3a51b02d108e6e
identifier_str_mv 10.57945/manara.25709358.v1
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/25709358
publishDate 2024
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rights_invalid_str_mv CC BY 4.0
spelling Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and ManagementMorounfolu Thompson (17045472)Sufia Athar (14777830)Rafael Gonzalez Olubunmi Oniya (18507536)Naglaa Mohamed (1378089)Yehia El Khawly (18466100)Kholode Al Maslamani (18507539)Lolwa Al Ansari (18466227)Biomedical and clinical sciencesClinical sciencesReproductive medicineAdnexal torsionAbdominal painOvarian massEmergency presentationVaginal bleedingQatar Health Congress 2023 and the 3rd Qatar Public Health Conference<h3>Background</h3><p dir="ltr">In Qatar, primary presentation of acute abdominal pain with most women is to the Emergency Department. Adnexal torsion is a rare time limiting surgical emergency with severe reproductive health consequences characterised by such a presentation, and firm diagnosis requires direct visualization at surgery.1 Accurate, timely diagnosis of adnexal torsion is crucial to predict the need for surgery and prevent complications, however information on signs and symptomatology reliability is limited in the medical literature. There is currently no relevant reported data from Qatar.</p><h3>Methods</h3><p dir="ltr">This study aimed to assess symptomatology reliability in prediction of surgically proven cases of suspected adnexa torsion presenting to Al Wakra Hospital in Qatar. A database review was conducted of all women with suspected adnexal torsion presenting to the Emergency Departments between 1st January 2017 and 31st December 2022. Clinical data were assessed following a literature review. Sensitivity, specificity and predictive estimates were calculated for each parameter with 95% confidence intervals (CI) included. </p><h3>Results</h3><p dir="ltr">Among 58 suspected cases, 39 (67.24%) were subsequently confirmed as adnexal torsion. The predominating symptomatology was: acute abdominal pain associated with vomiting, abdominal guarding, mass, and tenderness (Figure 1). Tachypnoea was absent in all suspected cases (Table 1). Abdominal tenderness had a very high sensitivity, 99.2% (CI 97.6-99.8%) and positive predictive value, 96.0% (CI 95.1-96.8), while the absence of vaginal bleeding showed a high specificity, 100% (CI 82.4-100%).</p><h3>Conclusion</h3><p dir="ltr">Emergency room presentation and triage of cases with suspected adnexal torsion for surgery can be improved using these study findings. The wide confidence intervals in some parameters reflects the wide variation in clinical presentation and current diagnostic uncertainty.3 It is interesting that tachypnoea does not appear to be a feature in our population while abdominal tenderness is a strong predictor especially when linked with absence of vaginal bleeding.</p>2024-05-26T08:57:03ZTextConference contributioninfo:eu-repo/semantics/publishedVersiontextconference object10.57945/manara.25709358.v1https://figshare.com/articles/conference_contribution/Suspected_Adnexal_Torsion_in_Qatar_Symptomatology_Reliability_in_Diagnosis_and_Management/25709358CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/257093582024-05-26T08:57:03Z
spellingShingle Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and Management
Morounfolu Thompson (17045472)
Biomedical and clinical sciences
Clinical sciences
Reproductive medicine
Adnexal torsion
Abdominal pain
Ovarian mass
Emergency presentation
Vaginal bleeding
Qatar Health Congress 2023 and the 3rd Qatar Public Health Conference
status_str publishedVersion
title Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and Management
title_full Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and Management
title_fullStr Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and Management
title_full_unstemmed Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and Management
title_short Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and Management
title_sort Suspected Adnexal Torsion in Qatar – Symptomatology Reliability in Diagnosis and Management
topic Biomedical and clinical sciences
Clinical sciences
Reproductive medicine
Adnexal torsion
Abdominal pain
Ovarian mass
Emergency presentation
Vaginal bleeding
Qatar Health Congress 2023 and the 3rd Qatar Public Health Conference