Ovarian Torsion

Question 1

What is the definition of ovarian torsion?

Answer 1

Twisting of the ovary and/or fallopian tube on its vascular and ligamentous supports, blocking adequate blood flow to the ovary.

Question 2

What causes ovarian torsion?

Answer 2

Hypermobility of ovary
Adnexal mass, most commonly dermoid cyst

Question 3

What are some clinical features of ovarian torsion?

Answer 3

Severe non-specific lower abdominal and pelvic pain (intermittent or sustained)
Nausea and vomiting
Adnexal tenderness

Question 4

What are some investigations for ovarian torsion?

Answer 4

Bloods (raised white cells)
Ultrasound (1st choice imaging)
CT (useful if USS normal)

Question 5

What is the management of ovarian torsion?

Answer 5

Urgent surgery:
- Salpingo-oophrectomy for unsalvageable ovaries (most common)
- Surgical untwisting for non-infarcted adnexa