Ovarian Torsion

Abstract

Adnexal torsion, commonly referred to as ovarian torsion , occurs when the vascular pedicle twists and may involve the Fallopian tubes and ovaries. The majority of patients with ovarian torsion present for initial evaluation to the emergency department (ED) (75%) rather than the primary care or gynecology clinic – and usually within 12 hours of symptom onset. The ovaries have a dual blood supply from the uterine and ovarian arteries, so complete arterial obstruction is rare. The differential diagnosis of atraumatic abdominal pain in women includes appendicitis, ovarian cysts, ectopic pregnancy, renal colic, urinary tract infection, pelvic inflammatory disease, malignancy, and diverticulitis. Ultrasound is generally considered the imaging technique of choice for ovarian torsion. Computed tomography is only 34% sensitive for the diagnosis of ovarian torsion and agrees with ultrasound results only 50% of the time.