A twisting of the ovary and/or fallopian tube on its vascular and ligamentous supports, blocking adequate blood flow to the ovary.
Rapid diagnosis and intervention are necessary to preserve ovarian function.
Most often seen in women of reproductive age between 20 and 40 years; can occur during pregnancy. Also seen in infants, children, adolescents, and post-menopausal women.
Commonly presents with abdominal pain, nausea, vomiting, and an abdominal mass. High clinical suspicion is necessary. Clinical presentation is non-specific, with no absolute clinical profile.
Transvaginal ultrasound with Doppler flow studies may show an enlarged ovary with absence of blood flow.
Definitive diagnosis is surgical. Laparoscopic surgery with detorsion is the preferred treatment to preserve normal ovarian function and fertility.
The twisting, or torsion, of the ovary around its ligamentous supports. This may result in loss of blood supply to both the ovary and the fallopian tube. When diagnosed, this condition is considered a surgical emergency. Therefore, reaching a correct diagnosis as quickly as possible is critical in order to prevent adverse events that may result in the loss of the ovary, fallopian tube, or both.
History and exam
Department of Obstetrics and Gynecology
Northeast Ohio Medical University
Aultman Health Foundation OB/GYN Residency
MPH declares that he has no competing interests.
Dr Michael P. Hopkins would like to gratefully acknowledge Dr Jay R. Patibandla, Dr John C. Nulsen, and Dr Vanessa N. Weitzman, the previous contributors to this topic.
JRP delares that he has no competing interests. JCN is an author of a reference cited in this topic. VNW is an author of a reference cited in this topic.
University Department of Obstetrics and Gynaecology
Royal Free Hospital
AM declares that he has no competing interests.
Department of Obstetrics
Gynecology and Reproductive Sciences
Division of Reproductive Endocrinology and Infertility
University of Pittsburgh
JS declares that he has no competing interests.
Associate Professor and Chief
General Division of Obstetrics and Gynecology
University of Utah School of Medicine
Salt Lake City
HS has been reimbursed for attending and participating in conferences on pelvic varicosity pain syndrome by Cook Inc.
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