Ovarian torsion

Case contributed by Dr Matthew Lukies

Presentation

3 hours of left lower quadrant abdominal pain and nausea. Negative beta-HCG.

Patient Data

Age: 25
Gender: Female
Modality: Ultrasound

Transvaginal pelvis ultrasound was performed, demonstrating:

  • enlarged left ovary that is very tender to ultrasound probe palpation
  • large anechoic cyst on the left ovary
  • no vascular flow in the left ovary
  • normal sized, non-tender right ovary with > 18 follicles
  • anteverted, mobile, non-tender uterus with normal appearance of the endometrium

These ultrasound findings are consistent with left ovarian torsion. The patient was referred urgently to the Gynaecology unit.

Case Discussion

The patient proceeded to the operating theatre under the Gynaecology unit, where a laparoscopy was performed. The left ovary was confirmed to be torted twice around, with a blue/black appearance. The ovary and adnexa were detorted and the colour subsequently improved. The large left ovarian simple cyst was drained. The uterus, right uterine tube and right ovary had normal appearance on laparoscopy.

Case thanks to Dr Alex Jarema and Dr Shamen Gunawardena.

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Case Information

rID: 50187
Case created: 23rd Dec 2016
Last edited: 26th Dec 2016
System: Gynaecology
Inclusion in quiz mode: Included

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