Successful laparoscopic management of adnexal torsion in early pregnancy: A case report

Abstract

Ovarian torsion is an urgent gynaecological surgery and can occur during pregnancy. Ovarian torsion during pregnancy carries significant risk to pregnant woman and intrauterine fetus. Diagnosing ovarian torsion during pregnancy can be challenging as most frequently ,patients present with abdominal pain and non specific symptoms. If the diagnosis of ovarian torsion is missed, it can lead to ovarian necrosis and sepsis with subsequent loss of ovarian and tubal function. This condition not only threatens the pregnancy but also has great implications for future fertility. A 26year-old G2P1L1 at 5 weeks gestational age presented to us with right sided lower abdominal abdominal pain radiating to back, burning micturation, and low grade fever. Ultrasound showed an enlarged edematous enlarged right ovary with two hemorrhagic cysts with absent flow on color Doppler. The patient underwent emergency laparoscopic surgery, during which the necrotic adnexa was removed. She was placed on progesterone therapy postoperatively and eventually delivered a healthy baby at term. Ovarian torsion though is extremely rare problem in pregnancy, it should be taken into consideration in differential diagnosis of abdominal pain.