Ovarian Torsion

Question 1

Cause?

Answer 1

ovarian mass >5cm–> cyst or tumour

Question 2

when else can this happen?

Answer 2

in young girls prior to menarche, when they have longer infundibulopelvic ligaments

Question 3

presentation?

Answer 3

• acute onset severe unilateral pelvic pain
  
  • constant
  • gets progressively worse
• nausea & vomiting
• low grade fever
• localised tenderness
• palpable mass

Question 4

Ix?

Answer 4

• TVUS
  
  • whirlpool sign
  • free fluid in pelvis
  • oedema of ovary
• doppler
  
  • lack of blood flow
• definitive = laparoscopic surgery

Question 5

Mx?

Answer 5

emergency admission (ischaemia–>necrosis) for laparoscopic surgery to either:

untwist & fix in place or remove ovary

Question 6

complications?

Answer 6

• delay= loss of function of the ovary
• if necrotic ovary not removed, can become infected –> abscess–> sepsis
• if ruptures–> peritonitis