Ovarian torsion

Case contributed by Dr Domenico Nicoletti

Presentation

Patient with pain in the iliac region for two days. Transabdominal ultrasound examination inconclusive.

Patient Data

Age: 30
Gender: Female
CT

Left ovary shows increased volume and density from haemorrhagic infarction (~50 HU) with torsion of the pedicle and moderate amount of low density free peritoneal fluid.

Case Discussion

Ovarian torsion (adnexal torsion) is an infrequent, but significant, cause of acute lower abdominal pain in women. This condition is usually associated with reduced venous outflow from the ovary, resulting in stromal oedema or internal haemorrhage. It can be caused by hyperstimulation or a mass. 

The clinical presentation is often nonspecific with few distinctive physical findings, commonly resulting in delay in diagnosis and surgical management. A quick and confident diagnosis is required to save the ovary from infarction.

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Case information

rID: 33967
Case created: 30th Jan 2015
Last edited: 6th Oct 2015
System: Gynaecology
Inclusion in quiz mode: Excluded

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