Adnexal torsion

Case contributed by Dr Utkarsh Kabra

Presentation

Acute left sided pelvic pain, ?renal colic

Patient Data

Age: 20 years
Gender: Female
MRI

Heterogeneously T2 hypointense structure containing possible areas of necrosis / hemorrhage measuring approx. 37 x 56 x 60 mm (AP X TD X CC) in left iliac region. Tiny T2 hyperintense cystic areas are seen at its periphery.
Cystic lesion measuring approx. 69 x 87 x 78 mm (AP X TD X CC) is seen in pelvis in midline, at inferior aspect of above mentioned T2 hypointense structure. It is compressing urinary bladder inferiorly, indenting anterior abdominal wall anteriorly and uterus posteriorly. No obvious solid component or areas of diffusion restriction is seen.

Case Discussion

Heterogeneously T2 hypointense structure containing possible areas of necrosis / hemorrhage in left iliac region. Tiny T2 hyperintense cystic areas are seen at its periphery, likely left ovarian torsion.

Cystic lesion in pelvis in midline, at inferior aspect of above mentioned T2 hypointense structure, compressing urinary bladder inferiorly, indenting anterior abdominal wall anteriorly and uterus posteriorly. No obvious solid component or areas of diffusion restriction is seen, possibly representing hydrosalpinx / ovarian / paraovarian cyst.

Patient was operated and left adnexal torsion was confirmed with left ovarian torsion and hydrosalpinx.

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