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Ovarian torsion

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Complaining of right-sided lower abdominal pain with vomiting for last few hours. There was no dysuria or loin to groin type pain.

Patient Data

Age: 25 years
Gender: Female
ultrasound

There is a thin-walled cyst (62 x 60 x 45 mm - 90 cc) in right ovary with tiny echoes within. There is no calcification/ septa/ nodule in the cyst. The residual parenchyma of the right ovary is compressed with peripherally oriented small follicles. There is a presence of venous flow as well as continuous forward arterial flow in the right ovarian parenchyma cranial to right ovary, there is twisted vascular pedicle.

The uterus and left ovary are normal.

Case Discussion

A young female presented with right-sided lower abdominal pain with vomiting. Ultrasound shows a right ovarian cyst with a twisted vascular pedicle (whirlpool sign) which is a primary sign of ovarian torsion.

Surgery was done within few hours which confirmed the findings. Intra-operative findings revealed a right ovarian hemorrhagic cyst. The ovary could not be salvaged.

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