Ovarian torsion

Case contributed by Dr Ammar Haouimi

Presentation

Five days history of non-specific lower abdominal, and pelvic pain with nausea, and vomiting.

Patient Data

Age: 35 years
Gender: Female
MRI

Enlarged left ovary (7.5 x 6.5 x 5.5 cm) of intermediate signal intensity on T1WI, low signal intensity on T2WI, containing a corpus luteal cyst as well as peripherally displaced follicles with twisted vascular pedicle giving the appearance of a whirlpool sign. The postcontrast sequences show a thin rim of peripheral enhancement (infarcted ovary). Mild intraperitoneal effusion.

The right ovary shows a normal appearance with a follicle of 2.7 cm in diameter.

The uterus is of normal shape, and size with thickening of the endometrium-myometrium junctional zone (thickness=15 mm) in keeping with adenomyosis

Case Discussion

MRI features of ovarian torsion (a triple torsion of the vascular pedicle was found at surgery).

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