Ovarian torsion occurs when the ovary and fallopian tube twist around themselves, causing the ovarian artery and vein that irrigate them to be withdrawn. The blood supply is totally or partially interrupted, causing a progressive death of the ovarian cells until the ovary can be lost definitively if the torsion is prolonged over time (hours or days).
Ovarian torsion occurs more frequently in women who have an ovarian mass, usually a simple cyst or other types of benign tumors, which make the ovary heavier than usual. Women who have suffered an ovarian torsion are more likely to suffer a second torsion, either of the same ovary or the opposite one.
It manifests itself with intense lower abdominal pain of abrupt onset, which varies in intensity over time, occurring in peaks. It may be accompanied by nausea, vomiting and fever.
Diagnosis is based on clinical examination and transvaginal gynecological ultrasound. Sometimes this is not enough and laparoscopic surgery must be performed to directly observe the ovary and reach a definitive diagnosis. This surgery is also the treatment of the torsion: the torsion is undone and if its condition allows it, the ovary is preserved. If an ovarian cyst or a benign tumor is observed, the intervention is used to remove them.
- M Laufer. Ovarian and tube torsion. UpToDate. Last updated 13 may 2021.
- F moro et al. Imaging in gynecological disease (20): clinical and ultrasound characteristics of adnexal torsion. Ultrasound Obstet Gynecol 2020; 56: 934–943.
