Introduction

Ovarian torsion may be defined as the partial or complete torsion of the ovary on it's supporting ligaments that may in turn compromise the blood supply. If the fallopian tube is also involved then it is referred to as adnexal torsion.

Epidemiology

  • Incidence: 6.00 cases per 100,000 person-years
  • Peak incidence: 30-40 years
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Aetiology

Risk factors
  • ovarian mass: present in around 90% of cases of torsion
  • being of a reproductive age
  • pregnancy
  • ovarian hyperstimulation syndrome

Clinical features

Features
  • Usually the sudden onset of deep-seated colicky abdominal pain.
  • Associated with vomiting and distress
  • fever may be seen in a minority (possibly secondary to adnexal necrosis)
  • Vaginal examination may reveal adnexial tenderness

Investigations

Ultrasound may show free fluid.

Management

Laparoscopy is usually both diagnostic and therapeutic.