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Presentations vary from asymptomatic pelvic masses to acute abdomen, and some ovarian tumors might present with precocious puberty or virilization. Acute pain might be caused by hemorrhage or rupture of ovarian or paraovarian cysts, adnexal torsion or adnexal infection. Differential diagnosis of adnexal masses should include peri\u2010appendiceal abscess in all age groups, and endometriomas and ectopic pregnancy in adolescents. This review provides guidance on the differentiation between adnexal abnormalities, based on important clues from clinical assessment and diagnostic workup, and ultimately on the decision making about the need for surgery, its level of urgency, and the type of surgery to clinicians of all specialties involved in the care of young females.<\/jats:p>","DOI":"10.1002\/ijgo.14574","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T07:49:59Z","timestamp":1668412199000},"page":"702-710","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Surgical disorders in pediatric and adolescent gynecology: Adnexal abnormalities"],"prefix":"10.1002","volume":"161","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1428-2312","authenticated-orcid":false,"given":"Anastasia","family":"Mentessidou","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery and Urology Cambridge University Addenbrooke's Hospital  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros","family":"Mirilas","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Aghia Sophia Children's Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,26]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Endocrine Development","author":"Sultan C","year":"2004"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1083-3188(98)70117-2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.347130144"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-48590-3"},{"key":"e_1_2_10_6_1","volume-title":"Ashcraft's Pediatric Surgery","author":"Holcomb GW","year":"2014"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.10100213"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2009.10.022"},{"key":"e_1_2_10_9_1","first-page":"1356","article-title":"International Society of Paediatric Surgical Oncology (IPSO) surgical practice guidelines","volume":"16","author":"Abib SCV","year":"2022","journal-title":"ecancer"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2005.01.002"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)63572-6"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001703-200210000-00004"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90420-1"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016348609158382"},{"key":"e_1_2_10_15_1","unstructured":"RitchieJ O' MahoneyF GardenA;British Society for Paediatric & Adolescent Gynaecology.Guideline for the management of ovarian cysts in children and adolescents.2018. 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