Ovarian torsion

Last reviewed: 25 Aug 2022
Last updated: 23 Feb 2021

Summary

Definition

History and exam

Key diagnostic factors

  • abdominal pain
  • nausea, vomiting, or diarrhea
  • abdominal/pelvic tenderness
  • palpable adnexal mass
More key diagnostic factors

Other diagnostic factors

  • feeding intolerance, vomiting, abdominal distention, and fussiness (neonates)
  • strenuous exercise
  • peritoneal signs
  • cervical motion tenderness
  • fever
Other diagnostic factors

Risk factors

  • ovarian neoplasm
  • ovarian cyst
  • paraovarian cyst
  • hydrosalpinx
  • pregnancy
  • infertility treatment
  • strenuous exercise
  • sudden increased abdominal pressure
More risk factors

Diagnostic investigations

1st investigations to order

  • CBC
  • pregnancy test
  • transvaginal ultrasound with Doppler flow
  • abdominal ultrasound
  • genetic probe or cervical culture
  • urinalysis
  • surgical visualization
More 1st investigations to order

Investigations to consider

  • CT abdomen/pelvis
  • MRI abdomen/pelvis
More investigations to consider

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Dr Sareena Singh, MD, FACOG

Assistant Professor

Department of Obstetrics and Gynecology

Northeast Ohio Medical University

Rootstown

OH

Chief of Gynecologic Oncology

Aultman Hospital

Canton

OH

Disclosures

SS declares that she has no competing interests.

Acknowledgements

Dr Sareena Singh would like to gratefully acknowledge Dr Michael P. Hopkins, Dr Jay R. Patibandla, Dr John C. Nulsen, and Dr Vanessa N. Weitzman, the previous contributors to this topic.

Disclosures

MPH, JRP and JCN declare that they have no competing interests. VNW is an author of a reference cited in this topic.

Peer reviewers

Adam Magos, BSc, MB, BS, MD, FRCOG

Consultant Gynaecologist

University Department of Obstetrics and Gynaecology

Royal Free Hospital

London

UK

Disclosures

AM declares that he has no competing interests.

Joseph Sanfilippo, MD, MBA

Professor

Department of Obstetrics

Gynecology and Reproductive Sciences

Vice Chairman

Reproductive Sciences

Director

Division of Reproductive Endocrinology and Infertility

University of Pittsburgh

Pittsburgh

PA

Disclosures

JS declares that he has no competing interests.

Howard Sharp, MD

Associate Professor and Chief

General Division of Obstetrics and Gynecology

University of Utah School of Medicine

Salt Lake City

UT

Disclosures

HS has been reimbursed for attending and participating in conferences on pelvic varicosity pain syndrome by Cook Inc.

  • Differentials

    • Ectopic pregnancy
    • Pelvic inflammatory disease (PID)
    • Appendicitis
    More Differentials
  • Guidelines

    • Adnexal torsion in adolescents
    • Guideline for the management of ovarian cysts in children and adolescents
    More Guidelines
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