Management of Ovarian Torsion: 2018 Pediatric Surgery Practice Gap #8

Join us as we continue our review of the top 10 practice gaps of 2018, first presented at last year's update course by APs practice Development Committee. Alex, what was number eight? So uh number eight was a topic near and dear to my heart, is uh ovarian torsion and just emphasizing that ultrasounds right now are not very good in terms of ruling out torsion. That an ultrasound is a horrible test for torsion. So in a patient with the suspected torsion, you got to go to the operating room. And when you're there, you don't take the ovary out even if it's black, you leave it there, you uh in order to preserve fertility and then you follow serially with ultrasounds in order to, you know, make sure that the ovary is staying healthy. When you reduce that torsion, then what do you do with that ovary? Leave it in. If it's black, it's dead. We've been trained up. We've been hit hit by rolled up newspaper enough that we know what to say now. All right, two questions. Why are ovaries near and dear to your heart? It's a it's a research topic of interest to me. So specifically the the ultrasound uh lack of sensitivity there and how we can try to improve that. That's great. And so what about Doppler flow? It shows that it's got uh Doppler flow? Do you do you still need to go to the operating room? Right now, yeah, even if there's flow there, doesn't mean that there's no torsion. It could be intermittently torsing, there may be a part that has blood flow. Something doesn't, so you still got to go. Okay.