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Ovarian Torsion

Marissa G. Sanderson, DO, Maeve K. Hopkins, MD and Michael P. Hopkins, MD, MEd Reviewed 06/2019
 


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%). Pain is localized to the involved side (right > left) but may radiate across the lower pelvis.

  • Associated nausea and vomiting in up to ...

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
Sasaki KJ, Miller CE. Adnexal torsion: review of the literature. J Minim Invasive Gynecol.  2014;21(2):196–202. [View Abstract on OvidMedline]
2
Huchon C, Fauconnier A. Adnexal torsion:...

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;33(5):438–441. [View Abs...

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

ICD9

  • 620.5 Torsion of o...

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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