Presentation
Three days history of severe intermittent pelvic pain with nausea, and vomiting.
Patient Data
Enlarged right ovary located in the Douglas pouch with stromal edema and hemorrhage and peripheral displacement of the follicles. No significant enhancement except for a central follicle that shows progressive peripheral enhancement on dynamic sequences. Thickened right ovarian pedicle with engorged vessels well-demonstrated on the postcontrast sagittal sequence as enhancing vascular structures. Free fluid in Douglas pouch, around the ovary.
Normal appearance of the uterus and left ovary containing small follicles.
Case Discussion
The clinical presentation and the MRI features are most consistent with right ovarian torsion that was confirmed at surgery.