Ovarian torsion

Case contributed by Dr Rania Adel Anan

Presentation

Virgin female patient presented with severe right pelvic pain not relieved by analgesia

Patient Data

Age: 25 years
Gender: Female

Transabdominal

Ultrasound

The right ovary itself is seen enlarged (3.7 x 5.4 x 5.5 cm in AP x ML x CC respectively) with echogenic stroma and peripherally displaced follicles. Doppler scan (not shown) revealed no internal vascularity. Impression of ovarian torsion.

A large well defined anechoic cystic lesion is seen at the mid pelvic region, encroaching upon the right adnexal region and inseparable from the right ovary. It is seen indenting the uterine body and displacing it posteriorly. It measures 7 x 10 x 12 cm and is in keeping with a large paraovarian cyst.

Pathology

Gross pathology specimen of torsed right ovary and large paraovarian cyst.

Case Discussion

Right ovarian torsion due to large para-ovarian hemorrhagic cyst.

Around 50% of torsions occur in ovaries that contain a lesion and around 50% of these lesions are dermoid cysts.

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