Approach

The presentation of ovarian torsion is non-specific, with no absolute clinical profile, which makes the diagnosis a challenge. In patients with confirmed ovarian torsion, correct pre-operative diagnosis is as low as 37% to 47%.[1][13] Therefore, when a female presents with pelvic or abdominal pain, ovarian torsion must be suspected. The difficulty for the clinician lies in differentiating between ovarian torsion and other aetiologies such as ectopic pregnancy, appendicitis, ovarian cysts, pelvic inflammatory disease (PID), urinary tract infection (UTI), nephrolithiasis, and endometriosis.

Although use of imaging modalities can assist in the diagnosis, the characteristic imaging features are not consistently detected. Therefore, the burden lies on clinical judgement.

A definitive diagnosis is based on surgical findings. It is imperative that ovarian torsion be suspected in order to be diagnosed and surgically managed to preserve ovarian function.

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