Ovarian Torsion AKA Adnexal torsion Flashcards
Is ovarian (adnexal) torsion a surgical emergency?
YUP
What is an ischemic condition, almost always associated with ovarian enlargement, and is generally due to ovarian cysts or masses?
Ovarian (adnexal) torsion
What are some risk factors for ovarian (adnexal) torsion?
- pregnancy
a. due to enlarged luteum - presence of large ovarian cysts or tumors
- chemical induction of ovulation
- tubal ligation
Ovarian enlargement causes the ovary to twist, causing venous congestion, leading to decreased distal arterial blood flow, producing what?
ischemia and necrosis of the ovary
Ovarian (adnexal) torsion
Process may involve the ovary alone, but what is more common
torsion of the ovary and oviduct (adnexal torsion)
What percentage of ovarian (adnexal) torsions occur on the right side?
70% (due to increased length of the utero-ovarian ligament on the right)
What may present with sudden onset of severe unilateral lower abdominal pain and may develop after episodes of exertion or athletics?
ovarian (adnexal) torsion
Half of patients with atypical symptoms of ovarian (adnexal) torsion have a gradual onset of intermittent pain, with nausea and vomiting presenting in what percentage of cases?
70%
What condition may present with the following?
- unilateral lower abdominal tenderness with gaurding
- unilateral adnexal tenderness on bimanual exam
a. about 30% of patients are bilaterally tender - possible palpable adnexal mass
Ovarian (adnexal) torsion
What imaging is used in possible ovarian (adnexal) torsion to determine decreased or absent blood flow and ovarian enlargement?
Transvaginal Ultrasound with Doppler flow
True or False
When ovarian torsion is suspected prompt gynecological surgical procedure is indicated
True
True or False
Most ovaries are viable even if they have some necrosis at the time of surgery for ovarian torsion
True, but gross necrosis would be an indicator for oophorectomy
