Adnexal torsion in the first trimester of a spontaneous pregnancy: detorsion and oophoropexy

Abstract

Introduction: Adnexal torsion is a rare cause of acute abdominal pain during pregnancy. In this case report, we present a case of adnexal torsion during the first trimester of pregnancy and its treatment. Case Presentation: A 28-year old, gravida 1, para 0 patient at 9 weeks gestational age presented to the antenatal clinic with acute abdominal pain in the right lower-abdominal quadrant. The patient was diagnosed with torsion of the right adnexa during pregnancy, and detorsion was performed. The patient was followed throughout the course of pregnancy. She delivered a healthy baby at term by caesarian section. During the caesarian section, both of the adnexa were observed to be normal. Conclusions: With acute abdominal pain, especially in the lower-abdominal quadrant during pregnancy, adnexal pathologies should be considered. Diagnosis of adnexal torsion during the first trimester of pregnancy is often missed due to the nonspecific clinical features and uncommon objective findings. Although surgical intervention should be considered to treat pregnant women suffering from adnexal torsion regardless of the gestational week, abdominal surgery carries some risks to the pregnant woman and unborn fetus.