Definition: Ovarian torsion is a medical emergency where an ovary twists around the ligaments supporting it, potentially cutting off blood supply and causing the tissue to die.
Location: Ovaries are oval-shaped glands located on either side of the uterus, involved in egg release and hormone production.
Adnexal Torsion: Sometimes the fallopian tube twists too, referred to as adnexal torsion.
Prevalence
Fifth most common gynecological surgical emergency.
Approximately 3% of emergency room visits for females involve ovarian torsion.
Symptoms
Sudden, severe abdominal pain.
Pain can be sharp, stabbing, or dull and crampy.
Located in the lower abdomen, often on the side of the affected ovary.
Additional symptoms: nausea, vomiting, fever, and abnormal vaginal bleeding or discharge.
Causes and Risk Factors
Common Causes: Large ovarian cysts or tumors adding weight to the ovary.
Risk Factors:
Age: Most common in individuals aged 29-34.
Presence of ovarian cysts or masses.
Longer-than-usual ovarian ligaments.
Pregnancy, especially with corpus luteum cysts.
Fertility treatments increasing risk of ovarian cysts.
Complications
Potential loss of the ovary if untreated.
Risk of infection (peritonitis) if tissue dies.
Diagnosis
Transvaginal ultrasound to detect lack of blood flow.
Definitive diagnosis through surgical exploration, often via laparoscopy.
Treatment
Surgery to untwist the ovary, potentially removing cysts (ovarian cystectomy).
Laparoscopy is the common procedure; sometimes open surgery (laparotomy) is needed.
Prevention and Prognosis
Ovarian torsion is not preventable.
Recurrence is rare; oophoropexy may be recommended for those with repeated torsion.
Surgery is successful in 90% of cases, preserving both ovaries.
Urgency and Emergency Care
Immediate ER visit recommended for unexplained lower abdominal pain.
Early treatment improves outcomes, preventing loss of an ovary or severe infection.
Questions for Healthcare Provider
Precautions during recovery.
Likelihood of recurrence and impact on fertility.
Signs of complications to monitor.
Additional Notes
Ovarian torsion can be life-threatening if it leads to severe infection.
Symptoms often drive individuals to seek medical care within 1-3 days.
Intermittent torsion can cause varying pain but requires medical evaluation.
Cleveland Clinic emphasizes the importance of fast action to preserve ovarian function and health.