A rare case of ovarian torsion in a pregnant patient

Torsion of the ovary is the total or partial rotation of the adnexa around its vascular axis or pedicle. It is an uncommon cause of acute abdominal pain in females, and it is a gynecologic emergency. The majority of the cases present in the pregnant (22.7%) than in non-pregnant (6.1%) women. Diagnostic delay can result in loss of the ovary. This twisting initially obstructs venous flow, which causes engorgement and edema. The engorgement can progress until arterial flow is also compromised, leading to ischemia and infarction. The increased use of ovarian stimulation and assisted reproductive technology has led to an increase in the risk of adnexal torsion, particularly in pregnant women or women with ovarian hyperstimulation syndrome (OHSS). The differential diagnosis of adnexal torsion is particularly difficult in combination with OHSS or pregnancy, as abdominal pain, nausea and vomiting can be presenting symptoms of hyperstimulation or pregnancy as well. Here, we report a case of ovarian torsion occurring in pregnancy in which diagnostic delay occurred due to confusion with OHSS leading to oophorectomy. Fertility conservation may have been possible in case of earlier diagnosis and prompt treatment.

Acute pancreatitis masquerading as an ovarian torsion: a rare case report

Ovarian torsion is a common diagnostic challenge constituting 2.7% to 7.4% of all gynaecological emergencies. It commonly occurs in women of reproductive age however pre-pubertal girls and postmenopausal women can also be affected. Ovarian torsion accounts for approximately 3% of all cases of children with acute abdominal pain and requires immediate surgical intervention. Other common acute adnexal pathologies include simple ovarian cysts (OCs) with or without rupture. Owing to the nonspecific clinical presentation and poor specificity of radiologic tests, the diagnosis of OT in girls remains challenging. Here we are reporting a case of acute abdomen with large cyst on ultrasound clinically presented as torsion later on in the post-operative period diagnosed with acute pancreatitis.

Ovarian Torsion Presentation, Treatment and Iatrogenic Surgical Management

Ovarian torsion is among the gynecological life-threatening conditions that may require urgent surgical intervention among the appearance of clinical manifestations. The most common clinical manifestations include severe abdominal pain, nausea extending to vomiting. The ovarian torsion is not limited to children only. However, it can also occur in adult females, either pregnant or non-pregnant. The etiology of the disease tends to be related to the weakness of the uterine ligaments or malpositioning of it due to known and unknown causes. Despite that, the surgical intervention is needed to release the torsion. Sometimes, it can lead to adverse events or side effects such as decreased blood flow to the surrounding structures. Which by role may lead to unpleasant complications and clinical manifestations of hemorrhage and shock. In this article, we reviewed the topic of ovarian torsion from different aspects, including the definition, causes, clinical evaluation, and clinical management and its common complications.