Ovarian torsion

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Última revisão: 3 May 2025
Última atualização: 15 Apr 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • pelvic or abdominal pain
  • nausea, vomiting, or diarrhoea
  • abdominal/pelvic tenderness
  • palpable adnexal mass
  • presence of risk factors
Detalhes completos

Outros fatores diagnósticos

  • feeding intolerance, vomiting, abdominal distension, and fussiness (neonates)
  • strenuous exercise
  • peritoneal signs
  • cervical motion tenderness
  • fever
Detalhes completos

Fatores de risco

  • ovarian neoplasm
  • functional ovarian cyst
  • para-ovarian cyst
  • hydrosalpinx
  • pregnancy
  • infertility treatment
  • strenuous exercise
  • sudden increased abdominal pressure
  • polycystic ovary syndrome
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • pregnancy test
  • urinalysis
  • FBC
  • group and save
  • sickle cell test
  • C-reactive protein (CRP)
  • transvaginal ultrasound
  • abdominal or transrectal ultrasound
  • Doppler flow
  • PCR, nucleic acid amplification test, or cervical culture
  • surgical visualisation
Detalhes completos

Investigações a serem consideradas

  • CT abdomen/pelvis
  • MRI abdomen/pelvis
Detalhes completos

Algoritmo de tratamento

AGUDA

all patients

Colaboradores

Consultores especialistas

Jackie Ross, BSc, MBBS, FRCOG

Consultant Gynaecologist and Clinical Lead

Early Pregnancy and Gynaecology Assessment Unit

King’s College Hospital NHS Foundation Trust

London

UK

Biografia

JR is Vice Chair of the Association of Early Pregnancy Units and a medical advisor to the Ectopic Pregnancy Trust. She is also a course organiser for the Royal College of Obstetricians and Gynaecologists (RCOG) advanced skills training in Early Pregnancy and Acute Gynaecology, and South London RCOG ultrasound training co-ordinator for Gynaecology.

Declarações

JR declares that she has no competing interests.

Agradecimentos

BMJ Best Practice would like to gratefully acknowledge the previous expert contributor, whose work has been retained in parts of the content:

Dr Sareena Singh, MD, FACOG

Assistant Professor

Department of Obstetrics and Gynecology

Northeast Ohio Medical University

Rootstown

Chief of Gynecologic Oncology

Aultman Hospital

Canton

OH

Disclosures: SS declares that she has no competing interests.

Revisores

Cecilia Bottomley, MBBChir, MD, MRCOG

Consultant Gynaecologist and Clinical Lead for Gynaecology Governance

University College London Hospitals NHS Foundation Trust

London

UK

Declarações

CB declares that she has no competing interests.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

American College of Obstetricians and Gynecologists. Adnexal torsion in adolescents: ACOG committee opinion no, 783. Obstet Gynecol. 2019 Aug;134(2):e56-63.Texto completo  Resumo

Ritchie J, O’Mahony F, Garden A. Guideline for the management of ovarian cysts in children and adolescents. British Society for Paediatric & Adolescent Gynaecology. Dec 2018 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

    • Ectopic pregnancy
    • Mittelschmerz due to ruptured graafian (dominant) follicle
    • Urolithiasis
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Imaging in gynecological disease: clinical and ultrasound characteristics of adnexal torsion
    • Guideline for the management of ovarian cysts in children and adolescents
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Ovarian torsion

    Mais Folhetos informativos para os pacientes
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