Kissing ovaries sign

Last revised by Mina Sameh Rizk on 21 Oct 2023

The kissing ovaries sign refers to the appearance seen when both ovaries are located in close proximity or are touching each other in the pouch of Douglas, usually due to pelvic adhesions, and may be seen on ultrasound, CT or MRI.

This sign is most frequently associated with the severe form of pelvic endometriosis, in which repeated bleeding causes adhesions with pulling of the ovaries toward the midline but can also be seen in pelvic inflammatory disease that presents with pyosalpinx/pelvic abscess, nevertheless, MRI can differentiate between the two conditions.

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