Ovarian pregnancy torsion

Abstract

Varying density distribution in the ovary can predispose to ovarian torsion. Emergency surgery may offer the possibility of avoiding the ablation of functional ovarian tissue. Early detection and prompt management can preserve fertility and ovarian function. The etiology, presenting syndrome and management are discussed.

Ovarian Torsion: A Gynecological Emergency

“…[4][5][6][7][8] Many anatomic and physiologic factors predispose a woman to experience torsion of the ovary, but the true etiology is not always identified. Pregnant women who conceive as a result of controlled ovarian stimulation are at greater risk for the development of ovarian torsion 5,6 as seen in our case series.…”

“…10 The first signs and symptoms of torsion develop when decreased venous and lymphatic return increases the size of the ovary, eventually arterial supply to the ovary is restricted as well, leading to ischemia and necrosis if left untreated. 4,8 It is crucial to identify torsion early to preserve the ovary. However, in cases in which the diagnosis is delayed and the ovary is found to be black or bluish in appearance on surgical examination, the ovary still may be salvageable.…”

“…This implies that full arterial constriction does not often occur; rather the edema and venous stasis may cause the mottled appearance of the affected ovary. 4,6 The imaging study of choice to diagnose ovarian torsion is Doppler ultrasound, as it may show absent or reduced blood flow to the ovary. 8 The ovary appears unilaterally enlarged with edema and multiple cystic structures that often are accompanied by some degree of ascites.…”

Torsion of Ovarian Cyst During Pregnancy (Laparoscopic Cystectomy): A Case Report

“…Conservative treatment appears to be warranted to preserve fertility, even for adnexa that initially appear nonviable and purple or black in color 16,17 . However, reestablishing ovarian pedicle has recently been shown to result in viable ovarian tissue on the affected side, with no systemic complications reported to date 11,17,18 .…”

Adnexal torsion in the first trimester of a spontaneous pregnancy: detorsion and oophoropexy

“…4,6 In addition, this procedure allows the physician to drain cysts, examine possible underlying causes of the torsion, and manually detorse the ovary. [12][13][14] Standard surgical techniques include laparotomy with detorsion or salpingooophorectomy.…”