Ovarian torsion

Case contributed by Marius I. Diaconescu

Presentation

Acute right lower quadrant pain, in a patient that is afebrile and known for a right ovarian cyst. Beta HCG negative.

Patient Data

Age: 20 years
Gender: Female
Ultrasound

The right ovary is diffusely enlarged overall.

The right ovary contains a partially collapsing functional cyst. The right ovary has a diffusely abnormal hypoechogenic texture. 

The right Fallopian tube is diffusely abnormally thickened. 

The findings are compatible with torsion of the right ovary and right Fallopian tube.

There is a moderate amount of clear free fluid in the pelvis.

Case Discussion

Comparison of both ovaries is often helpful to help identify ovarian torsion. Ultrasound is the best modality to evaluate for torsion, however, one must be aware of the appearance of ovarian torsion on CT, to be able to pick it up on this modality as well.  

 

Acknowledgement: Dr. Maria Tsatoumas

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