Ovarian torsion with hematosalpinx

Case contributed by Suresh Babu Boddapati

Presentation

Acute pelvic pain. No bleeding per vaginum.

Patient Data

Age: 40 years
Gender: Female

Multiple uterine fibroids are seen.

Left ovary is enlarged with an ~6x5.5cm sized cyst showing some T2 hypointense contents in dependant part (seen on posterior coronal sections on T2 & STIR images).

The left fallopian tube is enlarged and appears twisted with focal cystic dilatation with T2 hypointense fluid level in dependant part. 

Features suggestive of left ovarian torsion with left hematosalpinx.  

A simple cyst is seen in the right ovary. 

Intraoperative images

Photo

Procedure: Hysterectomy with left salpingo-oophorectomy. 

Operative findings:

  1. left ovarian hemorrhagic cyst with two loops of torsion
  2. left hematosalpinx 
  3. simple cyst in right ovary 
  4. normal right fallopian tube
  5. uterine fibroids 

Case Discussion

Left ovarian torsion with hematosalpinx.

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