Ovarian torsion

Case contributed by Dr Charlie Chia-Tsong Hsu

Presentation

Acute onset of left iliac fossa pain.

Patient Data

Age: 9
Ultrasound

The left ovary is grossly enlarged and abnormally positioned in the pouch of Douglas. The left ovary appears mildy echogenic with small peripheral cysts likely to reflect stromal oedema secondary to venous congestion. There is absence of vascular flow on colour Doppler. Small volume free fluid is present in the pelvis. 

The right ovary appears normal.   

Case Discussion

This is a classic case of left ovarian torsion. The torted ovary frequently flips posteromedially into the Pouch of Douglas and this is an important ancillary finding frequently under recognised.

The patient underwent urgent laparosopic detorsion procedure but unfortunately the left ovary was non-viable. 

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Case information

rID: 30264
Case created: 30th Jul 2014
Last edited: 19th Dec 2015
System: Paediatrics
Inclusion in quiz mode: Included

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