HWN Suggests

What are the four F's of ovarian torsion?

Female, Fat, Forty, Fertile = gall stones. We've heard that one before. I now propose the four F's of ovarian torsion:

• Female - goes w/o saying
• Fifty or less - affects women of reproductive age and younger (including adolescents, children and neonates)
• Funky ovary - 50 - 80% of ovarian torsion cases are associated with adenexal pathologic conditions such as ovarian tumors and cysts. When imaged using either pelvic ultrasound (modality traditionally used to image pelvic organs), CT or MR there is often an enlarged ovary or ovarian complex noted. The absence of doppler signal on duplex and color doppler…

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Articles of Interest

A review of ovary torsion

Ovarian torsion is a rare but emergency condition in women. Early diagnosis is necessary to preserve the function of the ovaries and tubes and prevent severe morbidity.

An update on the diagnosis and management of ovarian torsion

Delay or misdiagnosis can result in the loss of the affected ovary and subsequent reduced reproductive capacity. However, diagnosis can be difficult, particularly in intermittent torsion and the differential diagnosis can include several other gynaecological and surgical emergencies.

Diagnosing And Managing Ovarian And Adnexal Torsion In Children

This review looks at the evidence on diagnosing ovarian torsion, focusing particularly on diagnostic imaging modalities and the major guideline recommendations to effectively differentiate ovarian torsion from the many other possible causes of abdominal pain in the pediatric female.

How Doctors Take Women's Pain Less Seriously

When my wife was struck by mysterious, debilitating symptoms, our trip to the ER revealed the sexism inherent in emergency treatment.

How Ovarian Torsion can Stop you From Getting Pregnant

If ovarian torsions are diagnosed and treated early, then the prognosis is favorable. However, if diagnosis is delayed, the torsions can worsen and cut off arterial blood flow into and venous blood flow out of the ovary.

My Ovarian Cyst, Torsion and Surgery Story

I was moved on to the Gynae ward where a consultant finally came to see me. He told me in actual fact my cyst was about 8 cm and was bleeding. He said it had twisted (a torsion) and was cutting off the blood supply to my ovary.

Ovarian torsion clinical presentation

Classically, pathologic enlargement of an ovary serves to increase ovarian dimension and increase the risk for torsion. Indeed, most cases involve ovarian masses measuring 6 to 10 cm.

Ovarian Torsion, “Answers”

“Time is tissue” is a mantra that has been applied to various ischemic processes, including adnexal torsion. However, there does not seem to be a direct relationship between symptomatic time and ischemic tissue damage in torsion. The explanation for this discrepancy lies in the pathophysiology of torsion and in ovarian anatomy.

Ovarian torsion; a gynaecological emergency

Unfortunately ovarian torsion remains a diagnostic challenge for carers who look after women who present with abdominal pain in the emergency setting. A lot relies on a high index of suspicion and taking a good history and examination. It is strongly associated with ovarian cysts of around 5cm or more and these cysts tend to be dermoids.

Resources

Pediatric EM Morsels

We all know that abdominal pain is a common complaint that in the ED. The differential is vast and includes some terrible conditions (ex, Intussusception, Necrotizing Enterocolitis, Malrotation) as well as rather common conditions (ex, Constipation). Naturally, we have all been taught to think “outside the box” and know to consider conditions outside the abdominal cavity (ex, Pneumonia, Testicular Torsion). When we are thinking outside of the box, make sure we keep Ovarian Torsion on our DDx list for the young girls.

Society for Academic Emergency Medicine

The classic presentation of adnexal torsion is sudden onset of unilateral lower abdominal pain which is initially visceral in character (ie, vague and poorly localized) and may be accompanied by nausea and vomiting. It may radiate to the groin or flank.

Family Practice Notebook

Extensive professional reference.

Paediatric Emergency Medicine

Strangulated Hernias could rarely include an ovary - 4.9 cases/ 100,000. Ovarian torsion occurs in young women (63% in 7-10yr old), and post-menopausal women. 20% of cases occur during pregnancy.