Ovarian torsion OT is when an ovary twists on its attachment to other structures , such that blood flow is decreased. Risk factors include ovarian cysts , ovarian enlargement, ovarian tumors , pregnancy , fertility treatment , and prior tubal ligation. Treatment is by surgery to either untwist and fix the ovary in place or to remove it. The development of an ovarian mass is related to the development of torsion.
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It can be intermittent or sustained and results in venous, arterial and lymphatic stasis. It is a gynecological emergency and requires urgent surgical intervention to prevent ovarian necrosis. Ovarian torsion has a bimodal age distribution occurring mainly in young women years and post-menopausal women. There is adnexal tenderness.
A raised white cell count is common. The result of vascular compromise secondary to ovarian torsion is hemorrhagic infarction and necrosis, that can occur as rapidly as within hours of torsion onset. Torsion of a normal ovary more commonly occurs in young children when developmental abnormalities predispose the ovary to torsion, such as excessively long Fallopian tubes or an absent mesosalpinx.
In adulthood, causes include both benign and malignant ovarian tumors , polycystic ovaries and adhesions. In early pregnancy, a torsion can occur secondary to a corpus luteal cyst or laxity of the adjacent tissues. Secondary signs include free pelvic fluid, an underlying ovarian lesion, reduced or absent vascularity and a twisted dilated tubular structure corresponding to the vascular pedicle.
Urgent surgery is required to prevent ovarian necrosis. Most ovaries are not salvageable, in which case a salpingo-oophorectomy is required. If not removed, the necrotic ovary can become infected and cause an abscess or peritonitis. In the case of a non-infarcted adnexa, surgical untwisting can be performed. Mortality resulting from ovarian torsion is rare. Spontaneous detorsion has also been reported. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys.
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Once your system installs this update, you will not be able to upload new images. Please use another browser until we can get it fixed. On this page:. Quiz questions. Clinical, surgical and pathologic findings of adnexal torsion in pregnant and nonpregnant women. Surg Gynecol Obstet. Edit article Share article View revision history Report problem with Article. URL of Article.
Article information. System: Gynaecology. Tags: core condition , ultrasound , gynecology , abr certifying ultrasound. Support Radiopaedia and see fewer ads. Cases and figures. Figure 1: gross pathology Figure 1: gross pathology.
Case 1: torsion with dermoid Case 1: torsion with dermoid. Case 2 Case 2. Case 3 Case 3. Case 4 Case 4. Case 5 Case 5. Case 6 Case 6. Case 7: with dermoid cyst Case 7: with dermoid cyst. Case 8 Case 8. Case 9 Case 9. Case 10 Case Case left ovarian torsion Case left ovarian torsion.
Case 13 Case Case 14 Case Case 15 Case Case with large simple cyst Case with large simple cyst. Case 17 Case Case in early pregnancy Case in early pregnancy. Case 19 Case Case 20 Case Case 21 Case Case 22 Case Case 23 Case Loading more images Close Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys.
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No. 341-Diagnosis and Management of Adnexal Torsion in Children, Adolescents, and Adults
Aka: Ovarian Torsion. These images are a random sampling from a Bing search on the term "Ovarian Torsion. Search Bing for all related images. Started in , this collection now contains interlinked topic pages divided into a tree of 31 specialty books and chapters. Content is updated monthly with systematic literature reviews and conferences.
It can be intermittent or sustained and results in venous, arterial and lymphatic stasis. It is a gynecological emergency and requires urgent surgical intervention to prevent ovarian necrosis. Ovarian torsion has a bimodal age distribution occurring mainly in young women years and post-menopausal women. There is adnexal tenderness. A raised white cell count is common.