Ovarian torsion

Case contributed by Dr Maulik S Patel

Presentation

Lower abdominal pain with vomiting for 2 days.

Patient Data

Age: 20 years
Gender: Female
Ultrasound

Symptoms were milder on day 2. Ultrasound performed on 2nd day of symptoms.

Right ovary is normal. Uterus is normal.

Left ovary is enlarged: 126 cc. Ovary is anterior to uterus and more towards mid line. It abutts right ovary. There is a thin walled cyst in left ovary (58 cc). Cyst shows retracted avascular clot. Left ovarian residual parenchyma is odematous. There are hypoechoic ill-defined areas in ovary with presence of fluid clefts. Few islands of normal ovarian parenchyma are seen around follicles. Left ovarian arterial flow shows increased resistance (RI).

Case Discussion

Ultrasound shows secondary signs of ovarian torsion - changes in ovary. Primary sign of torsion - twisted vascular pedicle was searched for; but could not be localized during ultrasound. 

Surgery was done around 28 hours later: left ovarian torsion with non-viable ovary (source: primary operating surgeon).

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Case information

rID: 45829
Case created: 9th Jun 2016
Last edited: 10th Jun 2016
Inclusion in quiz mode: Included

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