Presentation
One day history of acute lower abdominal pain.
Patient Data
The right ovary appears grossly bulky with central edematous stroma and peripherally distributed follicles. The twisted pedicle is seen along the inferomedial aspect of right ovary and can be seen on axial post contrast study marked by a green arrow. There is no evidence of an ovarian cyst or dermoid.
There is a moderate amount of free fluid also noted in the pelvis.
Polycystic appearance of the left ovary.
Case Discussion
Ovarian torsion is considered as an emergency situation hence early diagnosis is essential in order to salvage the ovary. Most of the time a lead point is identified, including benign or malignant ovarian tumors or polycystic ovaries. Newer literature has also mentioned ovarian torsion in females undergoing treatment for infertility.
In the above case, the right ovary is bulky with central edematous stroma and peripherally distributed follicles. A twisted pedicle is very clearly demonstrated with lack of expected normal enhancement of ovary. The left ovary shows a polycystic pattern.
The above findings were confirmed intraoperatively. Unfortunately, no subsequent imaging was performed.
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