Adnexal torsion in a patient with bichorial twin pregnancy in the 21st week of gestation treated by open laparoscopy: a case report

Abstract

Adnexal torsion is a rare finding during pregnancy. Here we report a patient with bichorial twin pregnancy in the 21st week of gestation with adnexal torsion. She was admitted with acute abdominal pain. Open laparoscopy was performed and the left adnexa was unwinded successfully. The postoperative follow-up was uneventful. Adnexal torsion as differential diagnosis of acute abdomen in pregnancy should be considered seriously to avoid irreversible lesions of the ovary and (salpingo-) oophorectomy.

Ovarian torsion in in vitro fertilization–induced twin pregnancy: Combination of Doppler ultrasound and laparoscopy in diagnosis and treatment can quickly solve the case

“…It is suspected only in less than half of those pregnant patients with surgically proven twisted ovary (5). On the right side especially, an adnexal torsion could be confused with other acute abdominal conditions such as acute appendicitis, ureteral or renal colic, cholecystitis, and bowel obstruction (2). In IVF patients, everything is modified.…”

“…Main symptoms are nonspecific, and it is easy to misdiagnose an adnexal torsion with other acute abdominal diseases like appendicitis, urinary obstruction, ectopic pregnancy, hemorrhagic cysts, corpus luteal cysts, and ovarian hyperstimulation syndrome (2).…”

“…A quick evaluation and diagnosis is essential for a conservative, organ-preserving management, because after 36-48 hours irreversible lesions of the ovary are likely (2). Color Doppler ultrasound can be helpful and allows specific preoperative diagnosis (3).…”

The clinical characteristics and sonographic findings of maternal ovarian torsion in pregnancy

“…The characteristics and clinical findings of ovarian torsion in pregnancy have been mostly reported previously in isolated case reports and small case series (3)(4)(5)(6), and there appears to be limited information on the subject. The diagnosis of ovarian torsion in pregnancy may be a challenging one, because palpation of the ovaries and ultrasound imaging of the ovaries are more difficult than in nonpregnant patients.…”

Fallopian Tube Torsion: A Case Series

“…Laparoscopic surgery is safe, even during early pregnancy, and is preferred over laparotomy. 14,15 However, in developing countries, the facility for endoscopic surgery is limited; that explains why the laparotomy was done in the cases presented in this paper.…”