Ovarian torsion

Case contributed by Laila Adel Mohsen
Diagnosis certain

Presentation

Right lower quadrant pain for a few days

Patient Data

Age: 35 years
Gender: Female
ultrasound

The right ovary appears significantly enlarged (3 x 1.6 cm) with peripherally seated follicles. Free fluid is noted in the pelvis. The uterus and left ovary are normal.

mri

MRI confirms the enlarged right ovary with peripherally seated follicles. Significant hypointensity on T2 and lack of enhancement on post-contrast images suggest hemorrhagic infarction. The uterus and left ovary are normal.

Case Discussion

Ovarian torsion commonly occurs due to ovarian masses, benign or malignant cysts, polycystic ovaries (PCO) or adhesions. The vascular compromise leads to hemorrhagic infarction, which can ensue within hours of the onset of symptoms. 

In this case, no ovarian masses were detected.

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