Definition: Ovarian torsion is a medical emergency where an ovary twists around the tissues supporting it, potentially cutting off blood supply.
Consequences: Can lead to tissue death if not treated promptly.
Adnexal Torsion: When the nearby fallopian tube also twists.
Prevalence: It's the fifth most common gynecological emergency requiring surgery.
Symptoms and Causes
Symptoms
Sudden, severe abdominal pain.
Moderate to severe lower belly pain.
Nausea and vomiting.
Signs of dying tissue include fever and abnormal vaginal bleeding or discharge.
Pain characteristics: Sharp, stabbing, or dull and crampy; located throughout the lower belly or isolated to one side; can be constant or intermittent.
Causes
Ovarian cysts: Large cysts can cause the ovary to shift or twist.
Tumors or Masses: Can shift the weight and cause torsion.
Risk Factors
Age: Most common in reproductive years (ages 29-34).
Presence of ovarian cysts or masses.
Longer-than-usual ovarian ligaments.
Pregnancy and fertility treatments.
Triggers
Physical movements, intercourse, or activity can trigger symptoms.
Complications
Tissue death can lead to reduced fertility.
Rarely, can cause abdominal infection (peritonitis).
Diagnosis and Tests
Transvaginal Ultrasound: Detects lack of blood flow.
Definitive Diagnosis: Requires surgical observation, often via laparoscopy.
Management and Treatment
Surgery: Untwisting the ovary, possibly removing cysts.
Procedures: Laparoscopy or less commonly, laparotomy.
Prevention
Not preventable, but recurrent cases may require oophoropexy.
Rarely done in children to preserve future fertility.
Outlook / Prognosis
Most people recover with two functioning ovaries.
Surgery is successful in 90% of cases.
Living With the Condition
Seek ER care for unexplained lower abdominal pain, especially with known risk factors like ovarian cysts.
Additional Common Questions
Life-threatening: Rarely, but can lead to serious complications without treatment.
Symptom Duration: Seek care immediately; most see a provider within days.
Self-resolution: Rare and should not be relied upon. Seek treatment as soon as symptoms arise.
Prevention of Future Occurrences: Discuss with healthcare provider post-recovery.
Note
Fast action can save the ovary and potentially save a life. Seek medical care immediately for severe abdominal pain.
Reviewed on: July 23, 2024
Contact: Cleveland Clinic for appointments and more information.