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      Dolor pélvico en niñas y adolescentes: Hallazgos ultrasonográficos

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          Abstract

          Objetivo: Describir los hallazgos ultrasonográficos en niñas y adolescentes que consultaron por dolor pélvico entre marzo y octubre de 2008. Métodos: Estudio descriptivo. Muestra: 190 niñas y adolescentes que cumplieron con los criterios de inclusión. Ambiente: Servicio de Ginecología Infanto Juvenil del Hospital de Niños "Dr. José Manuel de los Ríos". Resultados: En total se estudiaron 11 niñas, 76 adolescentes tempranas, 75 en adolescencia media y 21 en adolescencia tardía. Los grupos fueron homogéneos para las medidas uterinas y ováricas. 57 pacientes consultaron por dolor pélvico, 9 por dismenorrea y 3 por hallazgo ultrasonográfico de tumor parauterino. En el grupo de edad que más hallazgos se encontraron fue en la adolescencia temprana (34 pacientes). En el 67,9 % no se encontró ningún hallazgo y el 32,1 % se encontraron hallazgos ultrasonográficos. El 16 % consultó por dolor pélvico agudo y el 84 % por dolor pélvico crónico. El 77,4 % consultó por dolor pélvico de tipo punzante y el 22,6 % por dolor pélvico tipo cólico. El folículo dominante fue el hallazgo ultrasonográfico encontrado en el mayor porcentaje de las pacientes (10,5 %). Conclusiones: El mayor porcentaje de las pacientes incluidas en este estudio tenía ultrasonido pélvico normal. El ultrasonido es el método aceptado como la primera modalidad diagnóstica por imágenes en pacientes con dolor pélvico.

          Translated abstract

          Objective: To describe the ultrasonographic findings in children and adolescent girls that consulted for pelvic pain between March and October 2008. Methods: Descriptive study. Sample: 190 children and adolescent girls that met the inclusion criteria. Setting: Servicio de Ginecologia Infanto Juvenil del Hospital de Niños "Dr. Jose Manuel de los Rios". Results: A total of 11 children, 76 early, 75 medium and 21 late adolescent girls were studied. The groups were homogeneous for the uterine and ovarian measurements. 57 patients consulted for pelvic pain, 9 for dysmenorrhea and 3 for ultrasonographic findings of para uterine tumors. The age group with more findings was the early adolescence (34 patients). In 67.9 % there were no findings and in 32.1 % ultrasonographic changes were found. The 16 % consulted for acute pelvic pain and 84 % for chronic pelvic pain. The 77.4 % consulted for sharp pelvic pain and 22,6 % for colic pelvic pain. The dominant follicle was the ultrasonographic finding in the higher percentage of patients (10,5 %). Conclusions: The higher percentage of patients included in this study had a normal pelvic ultrasound. The ultrasound is the accepted method for diagnostic of images in patients with pelvic pain.

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          Most cited references35

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          Terms, definitions and measurements to describe the sonographic features of adnexal tumors: a consensus opinion from the International Ovarian Tumor Analysis (IOTA) Group.

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            Pelvic organs in premenarcheal girls: real-time ultrasonography.

            Age-related changes in uterine and ovarian morphology and size were studied in 114 normal premenarcheal girls using a real-time mechanical sector scanner. Reference growth values were obtained for total uterine length, anteroposterior diameters of the corpus and cervix, corpus/cervix ratio, and uterine and ovarian volumes. Up to 7 years of age uterine size was not influenced by age and there was a relative predominance of the cervix over the corpus. Thereafter the uterus underwent a regular increase in size and the corpus gradually became larger than the cervix. Ovarian volume was relatively stable up to 5 years, when regular age-related growth started, associated with an increase in cystic functional changes in the ovary. As uterine and ovarian morphology and size are reliable indicators of the degree of sex-hormone stimulation, real-time ultrasound offers a rapid method of studying normal and abnormal pubertal development in girls.
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              Pubertal maturation of the internal genitalia: an ultrasound evaluation of 166 healthy girls.

              Pelvic ultrasound is an important tool in the management of children with disturbances of pubertal development; interpretation requires an understanding of the normal relationship between maturation of internal genitalia and the appearance of secondary sex characteristics. We performed pelvic ultrasound examinations in 166 healthy females aged 6.4-25.4 years, and related uterine and ovarian volumes and size of follicles to age and pubertal stage. We demonstrated growth of the uterus and ovaries before the appearance of breast development and pubic hair growth. In prepubertal girls, uterine and ovarian growth was related to height (p = 0.008 and p = 0.010, respectively). From breast stages 1-5, median uterine and ovarian volumes increased from 1.6 ml to 43 ml, and from 1.2 ml to 7.3 ml, respectively (p < 0.0001). Uterine growth continued several years after menarche. Postmenarcheal uterine growth was related to the number of years after menarche (p < 0.001), but not to height, weight or age. Follicles were seen in 86% of prepubertal girls and in 99% of pubertal girls. Follicles up to 8 mm in diameter were observed in prepubertal girls. Maturation of the internal genitalia begins before the onset of clinical puberty, and extends well into the second decade.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                og
                Revista de Obstetricia y Ginecología de Venezuela
                Rev Obstet Ginecol Venez
                Sociedad de Obstetricia y Ginecología de Venezuela (Caracas )
                0048-7732
                December 2009
                : 69
                : 4
                : 239-244
                Affiliations
                [1 ] Hospital de Niños Dr. José Manuel de los Ríos Venezuela
                Article
                S0048-77322009000400005
                ea77243b-e2b0-4ede-885d-ac66bc8ec647

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0048-7732&lng=en
                Categories
                OBSTETRICS & GYNECOLOGY

                Obstetrics & Gynecology
                Pelvic pain,Ultrasonographic findings,Children,Adolescents,Dolor pélvico,Hallazgos ultrasonográficos,Niñas,Adolescentes

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