Presentation
Acute right iliac fossa pain. B-HCG negative.
Patient Data
Right ovary is enlarged, measuring (77 x 48 x 45 mm - 86 ml), appearing echogenic, with peripherally displaced follicles (follicular ring sign). Ovary appears medialised, lying almost posterior to the uterus, and approximates the left ovary. Some vascularity is seen. Right fallopian tube appears enlarged. No normal right ovarian parenchyma seen. No definite underlying lesion.
Left ovary has multiple follicles and is mildly enlarged, measuring 42 x 28 x 30 mm (18.8 ml).
Moderate volume of free fluid throughout the pelvis.
Anteverted uterus appears normal. Endometrium measures 11 mm thickness. Cervix appears normal, measuring 32 mm length.
Case Discussion
Typical imaging features of ovarian torsion. Confirmed intraoperatively, with a ruptured cyst thought to be the lead point.