C OMPLETE torsion of the tube and ovary complicating pregnancy is a relatively rare condition and is very difficult to diagnose. Careful search of gyneeologic and obstetric publications, as well as current textbooks, provides very little information on the subject. Corporeal movements and peristalsis are given by most authors as probable causes of torsion of the tube and ovary as seen in the nonpregnant state. When accompanying pregnancy it has been suggested that an abnormally large corpus luteum may precipitate the condition. The symptoms are generally acute abdominal pain, tenderness and rigidity, occasionally accompanied by vomiting and elevation of temperature. A well-market1 chemical peritonitis may follow t.ke estmvwntion of blood into the peritoneal cavity. The severity of the symptoms is generally tlt~l~entlmt upon the tlrgree of torsion and amount of interference with the bloo~l sul,l)ly of the afYec:tetl organs. Depending upon the lo&ion of the tumor, vesical am1 rtxctal symptoms may be well marked. The pathologic changes art’ due almost c~utircly to a sudden interference with blood supply. This circulatory tlisturbame lirst manifests itself by a hyperemia, later by edema, and finally by gangrenc with au entire obliteration of structure. Mrs. II. L., twenty-nine years of age, 1~:~:~ ii, was first seen in consultation on the afternoon of Dec. 12, 1934. ‘lYiree days before, the ljatient had developed sudden excruciating pain in the right lower quatlront. The pain was only partially relieved by large doses of morphine. The l&cm at that time thought that she was about six weeks pregnant. The following morning 11lood tinged urine was passed, and a diagnosis of urethral calculus was mallc 1,~ the family physician. The pain had subsided in part in the afternoon that the llatirnt was seeu in consultation. There was no temperature elevation but a slight imrease in the pulse rate. There was no vaginal bleeding. Upon examination the abdomen was slightly tlistendetl throughout, with marked tenderness and muscle spasm over the right lower quadrant. Pelvic examination revealed a large tender mass in the culdesacl. The cervix was displaced anteriorly, but because of the marked tenderness the hotly of the uterus could not be definitely outlined. In spite of a rather atypil’al history. :L ~liagnosis of ruptured tullal pregnancy was made. An exploratory laparotomy was performt2d. When the peritoneum was incised, a large amount of blood tinged fluid escaped. The right tube and ovary had undergone complete torsion and were gangrenous. The uterus was enlarged to the size of a six to eight weeks’ pregnancy. There was no evidence of a corpus luteum of pregnancy in the uninvolved ovary. The right tube and ovary were removed and the abdomen closed without drainage. On the third postol)erative day the patient aborted, otherwise the convalescence was uneventful. Pathologio Diagnosis.-The specimen consisted of two fragments of what appeared to be blood clot. DifI’usely hemorrhagic and no structural details could be identified. Microscopic Ezaminntion..-The outlines of many greatly dilated vessels can be made out, but other than these shadowy outlines diffuse hemorrhage and necrosis prevent recognition either of the nature of the tissue or the process by which it was destroyed. Diagnosis.-Hemorrhagic necrosis of unidentifiable tissue.