Ovarian torsion Flashcards
Define ovarian torsion.
Ovarian torsion is a twisting, or torsion, of the ovary around its ligamentous supports.
What is the aetiology of ovarian torsion? What are risk factors of ovarian torsion?
Underlying anatomical abnormalities account for the highest percentage of patients with ovarian torsion. Just over half (56%) of patients in a large series of adnexal torsion had an ovarian mass, mostly with benign histology, including dermoid cysts and para-ovarian cysts. The likelihood of a malignancy is greater in post-menopausal women.
Summarise the epidemiology of ovarian torsion.
Ovarian torsion is thought to account for approximately 3% of all gynaecological surgical emergencies.
What are the signs and symptoms of ovarian torsion?
Pelvic or abdominal pain
Nausea, vomiting, or diarrhoea
Abdominal/pelvic tenderness
Palpable adnexal mass
What investigations should be performed for ovarian torsion?
Pregnancy test
Urinalysis
FBC
Group and save
Sickle cell test
Transvaginal ultrasound
Abdominal or transrectal ultrasound
Doppler flow
PCR, nucleic acid amplification test, or cervical culture
Surgical visualisation
What is the management for ovarian torsion?
Surgical detorsion or salpingo-oophorectomy
What are complications associated with ovarian torsion? What is the prognosis for ovarian torsion?
Ovarian atrophy
Peritonitis
Excellent prognosis and retention of ovarian function is expected with timely surgical intervention.