Ovarian torsion

Case contributed by Maulik S Patel
Diagnosis certain

Presentation

Right lower abdominal pain with nausea for about 10 hours.

Patient Data

Age: 10 years
Gender: Female
ultrasound

The right ovary is enlarged without a mass lesion. The ovarian parenchyma is heterogeneously hypoechoic. Hyperechoic rim is present around a few ovarian follicles. There is an absence of color flow signals in the right ovary.  There is a twisted vascular pedicle close right ovary which is better appreciated in the cine loop.

The left ovary shows a normal volume, echopattern with normal parenchymal flow signals. The uterus is normal.

There was no abnormality in the rest of the examination of the abdomen and pelvis.

Case Discussion

A girl presented with right lower abdominal pain. Ultrasound shows a primary sign of ovarian torsion which is a whirlpool sign. There are secondary changes in the ovary like follicular ring sign 1, ovarian edema, absent parenchymal flow.

A laparoscopy was done within a few hours. There was torsion of the vascular pedicle with the edematous right ovary. Detorsion was done. The right ovary was viable and was fixed.

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