Ovarian torsion with twisted pedicle (ultrasound)

Case contributed by Annemieke Littooij


No relevant previous history. Severe pain in the right lower abdomen with vomiting. No fever.

Patient Data

Age: 10 years
Gender: Female

There is an enlarged right ovary located in the midline of the abdomen, just behind the uterus. There is a complex cystic lesion within this right ovary with a component that contains multiple echogenic lines and dots (dot-dash sign) representing hair in fluid. This is considered a characteristic sonographic sign of (mature) ovarian teratoma/dermoid. The video clip nicely shows the twisted pedicle and fallopian tube. 

Case Discussion

Right ovarian torsion was confirmed during surgery. The pathological specimen demonstrated a mature cystic teratoma (including hair in cyst)

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