Ovarian torsion

Case contributed by Abdulrahman Abdo Ali Abbas
Diagnosis almost certain

Presentation

Recurrent dull lower abdominal pain for two months, she was suspected to have left solid adnexal tumor on ultrasound.

Patient Data

Age: 25 years
Gender: Female

Pelvis

mri

Markedly enlarged left ovary, it is seen prolapsed to the Douglas pouch and is located in the midline pushing the uterus anteriorly. It exhibits marked stromal edema and hemorrhage with displaced follicles peripherally. T1 hyperintensity of the rim is noted in the enlarged ovary and the post-contrast T1-WI showed that the affected ovary is not enhancing, and only thin peripheral wall enhancement is present. A twisted left adnexal pedicle is also noted. No associated adnexal cystic, solid, or suspicious lesions. The right ovary reveals average follicular reserve for the age.

Case Discussion

The MRI features are characteristic for left ovarian torsion and left ovarian infarction. Unilateral salpingo-oophorectomy was performed for the patient.

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