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Ovarian Torsion

Jeremy Golding, FAAFP, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Rotation (complete or partial) of the ovarian vascular pedicle on its long axis; perhaps more accurately referred to as “adnexal torsion” because the fallopian tube is commonly invol...

DIAGNOSIS

HISTORY

  • The most common symptom is pelvic pain (96%), often but not always abrupt in onset. Pain is localized to the involved side (right > left) but may radiate across the lower pelvis.

  • As...

TREATMENT

GENERAL MEASURES

Surgery is the definitive treatment of choice. 

MEDICATION

Pain relief can be obtained with medication; however, surgical detorsion is the only definitive treatment. 

SURGERY/OTHER PROCEDURES

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Patients with cystic lesions managed conservatively at the time of torsion diagnosis may require additional surgical intervention if those lesio...

REFERENCES

1
Bridwell RE, Koyfman A, Long B. High risk and low prevalence diseases: Ovarian torsion. Am J Emerg Med. 2022;56:145-150. doi: 10.1016/j.ajem.2022.03.046. PMID: 35397355.
2
Didar H, Najafiara...

ADDITIONAL READING

Christopoulos  G, Goubet  S, Kelly  T. Interleukin-6 for the diagnosis of ovarian torsion: a systematic review and meta-analysis. J Obstet Gynaecol.  2013;...

CODES

ICD10

  • N83.51 Torsion of ovary and ovarian pedicle

  • Q50.2 Congenital torsion of ovary

  • N83.53 Torsion of ovary, ovarian pedicle and fallopian tube

  • N83.52 Torsion of fallopian tube

SNOMED

  • 13595002 Torsion...

CLINICAL PEARLS

  • Diagnosis of ovarian torsion can be delayed or missed, so a high clinical suspicion (especially in patients at high risk) is paramount.

  • Risk of torsion is increased during pregnancy, es...

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