Ovarian torsion is caused by rotation of the ovary or adnexa with the vascular pedicle on its axis, resulting in arterial, venous, or lymphatic obstruction. As you work through this case study, you will be asked to reflect on the investigations required, test results and management of the woman described in this case. Of those, 3% of cases are attributed to ovarian torsion. UK prices shown, other nationalities may qualify for reduced prices. 1 Introduction. You do not currently have access to this tutorial. 2012 Jul/Ago;45(4):225–229 positioning. Adnexal torsion can occur at any age, from intrauterine life to post-menopausal [1,2]. Introduction. The following case study discusses a patient who presents to the surgical assessment unit with a history of left iliac fossa pain. During controlled ovarian stimulation, a 34-year-old woman complained of right lower abdominal pain after the decision to retrieve oocytes. Although it can be idiopathic, it is frequently due to a cystic or solid ovarian mass. The clinical presentation of OT often consists of vague abdominal complaints, making the diagnosis difficult. Ovarian torsion is determined when an ovary becomes twisted on its ligamentous supports and can result in compromised blood supply to the ovary . Ovarian torsion is a surgical emergency demanding timely diagnosis and treatment to prevent loss of the ovaries which if happens may result in functional and emotional consequences. 7, pp. Abstract:Introduction: Ovarian torsion, traditionally managed with oophorectomy, there is evidence that a more conservative approach - detorsion/untwisting of the ovary - is an effective strategy. Ovarian torsion (OT) in the pediatric population is rare. The incidence in the paediatric population is 0.02% [3]. Ovarian torsion is a potential complication of gonadotrophin stimulation, which prompts practitioners to caution patients against strenuous activity during the stimulation cycle. 721–725, 2015. Ovarian torsion (adnexal torsion) occurs when an ovary becomes twisted around the tissues that support it. Ovarian torsion (OT) in the pediatric population is rare. The clinical symptoms of ovarian torsion are variable and nonspecific. Author: Carlos A. Suárez-Quian PhD • Reviewer: Joel A. Vilensky PhD Last reviewed: August 31, 2020 Reading time: 10 minutes In this article, we describe a case of a pregnant woman who presented with acute abdominal pain, vomiting, guarding, and rigidity. It is a condition that occurs when an ovary twists around the ligaments that hold it in place. 35, no. endobj stream Ovarian torsion occurs when the ovarian vascular pedicle performs a complete or partial rotation around its axis with consequent impairment in vascular supply [].Torsion is considered the 5th most common surgical emergency in women, accounting for more than 3% of all gynaecological emergencies []. Methods: A retrospective review was … Ovarian torsion was suspected and confirmed, so aspiration of follicular fluid was performed prior to oocyte retrieval for volume reduction of the affected ovary. Ovarian torsion involves torsion of the ovarian tissue on its pedicle leading to reduced venous return, stromal edema, internal hemorrhage, and necrosis [6] [1]. Keywords. Complications may include infection, bleeding, or infertility. Ovarian torsion (OT) is a serious condition, and delay in surgical intervention may result in loss of the ovary. Introduction Ovarian torsion, also known as adnexal torsion, is an infrequent cause of acute abdominal pain (AAP) in adult women (2.7% of cases of acute gynecologic complaints) which typically affects the ovary and the fallopian tube [1]. Ovarian torsion is a complete or partial rotation of the vascular pedicle of the ovary, impeding the blood flow of the ovary. The presentation of ovarian torsion can mimic many other intraabdominal pathologic conditions. Introduction Ovarian torsion is a potential complication of gonadotrophin stimulation, which prompts practitioners to caution patients against strenuous activity during the stimulation cycle. 1. The appearance was nonspecific, ranging from solid to cystic, but frequently reflected the commonly associated ovarian pathology present in 69% of patients. Also similar, the testicle swells, is very painful and will result in degeneration of the testicle if not corrected. It is a gynaecological emergency and requires urgent surgical intervention to prevent ovarian necrosis. This case involves a pre-pubertal girl. Testicular torsion involves testicular rotation in the same way that ovarian torsion involves rotation of the ovary. DefinitionOvarian torsion (OT) refers to the rotation ofthe ovary to such a degree as to occlude theovarian artery or vein.It is an infrequent but significant cause of acutelower abdominal pain in women. Introduction. When the patient is pregnant this can also lead to fetal mortality and potential loss of fertility for the patient. 1. Symptoms typically include pelvic pain on one side. Although it can be idiopathic, it is frequently due to a cystic or solid ovarian mass. Ovarian torsion has a bimodal age distribution occurring mainly in young women (15-30 years) and post-menopausal women. Traditionally, necrotic appearance has been synonymous of oophorectomy, however the current trend defends ovary preservation. Ovarian torsion involves the rotation of the ovary on its ligamentous supports often leading to interruption of its blood supply and in some cases necrosis. This cuts off the blood supply to the ovary, which if not treated promptly, can cause tissue in … Introduction Ovarian torsion involves torsion of the ovarian tissue on its pedicle leading to reduced venous return, stromal edema, internal hemorrhage, and necrosis. but is a common diagnostic challenge in emergencies. Simple (less than 5cm in size) ovarian cysts require follow-up for potential self-resolution. INTRODUCTION. Ovarian torsion is determined when an ovary becomes twisted on its ligamentous supports and can result in compromised blood supply to the ovary . However, heightened awareness and suspicion of this condition are needed for timely intervention. Purpose An early diagnosis of ovarian torsion is sometimes difficult due to variable clinical symptoms and non-specific imaging findings. Introduction. Objective(s): To increase awareness of the success rate of the Adnexal torsion Ovarian torsion Pediatric Surgical managementAdolescent KEY POINTS Adnexal torsion is rare, but does account for 2.7% of all cases of abdominal pain in chil-dren and adolescents and is the fifth most common gynecologic emergency. Introduction. Ovar-ian torsion refers to complete or partial twisting of the vascular pedicle in the suspensory ligament, leading to obstructed lymphatic flow followed by obstructed venous flow and finally obstructed arterial flow. Ovarian torsion is a surgical emergency that typically occurs in reproductive age women with ovarian masses , , .Less commonly, ovarian torsion is found in younger girls and adolescents with seemingly normal ovaries , , , .Adnexal torsion may involve the ovary, tube, or both structures. You can claim CPD points for completing this case study in either the knowledge-based assessment category or the personal/professional category. 1, 2 Initial clinical and sonographic evidence is often misleading. Two days after that, oocytes were successfully collected. Background . You can access the Management of possible ovarian torsion case study tutorial for just £48.00 inc VAT.UK prices shown, other nationalities may qualify for reduced prices.If this tutorial is part of the member benefit package, Fellows, Members, registered Trainees and Associates should sign in to access the tutorial. 3 0 obj Introduction. Ovarian torsion is the fifth most common gynecologic surgical emergency (,1). Ovarian torsion is characterized by a twisted ovary with or without the involvement of the fallopian tube. New users can register here. The purpose of this study was to determine preoperative features of patients with ovarian cyst that could be used in differentiation. Introduction. 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