Acute ovarian torsion is an uncommon yet important diagnostic consideration in any female pediatric patient presenting with acute abdominal pain. A 2-month-old infant presented to the emergency department with a several-day history of constipation. [ncbi.nlm.nih.gov]

• Severe Pain

  Twisting causes sudden, severe pain and often vomiting. Doctors use an ultrasound device inserted into the vagina (transvaginal ultrasonography) to confirm the diagnosis. Surgery is done immediately to untwist the ovary or to remove it. [msdmanuals.com]

  Patient usually presents with acute severe pain abdomen and pelvic examination may reveal a tender cystic mass separate from the uterus. The risk of ovarian torsion rises by 5 fold during pregnancy. Incidence is 5 per 10,000 pregnancies[ 1 ]. [casesjournal.biomedcentral.com]

  When present, it is often associated with severe pain. Etiology and pathophysiology Ovarian torsion is the total or partial rotation of the adnexa around its vascular axis. [mdmag.com]

  In patients with prior ovarian torsion, 11% were likely to recur, and of those, women with normal anatomy are at greater risk. [5,6] Clinical Presentation The classic presentation of ovarian torsion includes acute onset of moderate to severe pain with [emdocs.net]

• Chills

  Pyelonephritis may present with fever, chills, and pain at the costovertebral angle. Urinalysis and urine cultures to show presence of bacteria. [online.epocrates.com]

  The patient had no previous history of similar episodes in the past and denied fever, chills, headache, dysuria, constipation, diarrhea, menorrhagia or dysmenorrhea. [omicsonline.org]

  Fever and chills can occur but are more likely to occur with premenarchal females since their course is typically slower at onset with later presentation to the ED for care. [emdocs.net]

• Soft Tissue Mass

  Evaluation with plain radiographs demonstrated a subtle yet persistent soft tissue mass in the right pelvis. [ncbi.nlm.nih.gov]

• Abdominal Pain

  Abdominal pain is one of the most common chief complaints of patients presenting to emergency departments, and emergency physicians (EPs) often evaluate patients with right lower quadrant abdominal pain. [ncbi.nlm.nih.gov]

• Nausea

  A middle-aged female presented with a 5-day history of cramping abdominal pain and nausea and vomiting. Abdominal wall guarding and rebound tenderness was noted on examination. [ncbi.nlm.nih.gov]

  Listen for key features on history: sudden onset of unilateral pelvic pain, sometimes radiating to the groin, often associated with nausea and vomiting. [cdemcurriculum.com]

  Other symptoms may include nausea. Complications may include infection, bleeding, or infertility.Risk factors include ovarian cysts, ovarian enlargement, ovarian tumors, pregnancy, fertility treatment, and prior tubal ligation. [en.wikipedia.org]

• Lower Abdominal Pain

  Given the higher risk of malignancy in post-menopausal women, ovarian mass-related torsion is an uncommon but important cause of acute-onset lower abdominal pain. [ncbi.nlm.nih.gov]

  Ovarian cysts Lower abdominal pain with adnexal fullness on exam. Imaging or laparoscopy may be needed to distinguish from ovarian torsion. Ultrasound shows ovarian cysts and lacks features suggestive of torsion. [online.epocrates.com]

• Severe Abdominal Pain

  Abstract We report a case of pregnancy luteoma, which had undergone torsion in a 33-year-old Indian woman, who presented with severe abdominal pain and decreasing haemoglobin levels at 33 weeks gestation. [ncbi.nlm.nih.gov]

  Comments: This salpingo-oophorectomy specimen is from an adult female who presented with severe abdominal pain. Ultrasound examination revealed multicystic ovarian lesion which was removed at laparotomy. [webpathology.com]

  If this were to happen, you would have severe abdominal pain and you might feel like throwing up or even feel like passing out. If you have any of these symptoms, you should see your HCP immediately or go to the closest hospital emergency room. [youngwomenshealth.org]

  pain that comes on quickly. [en.wikipedia.org]

• Left Lower Quadrant Pain

  They are more likely to present with fever and diffuse pain, rather than focused right or left lower quadrant pain. The most common presenting symptom is pelvic pain followed by the history of or a palpable adnexal mass on physical exam. [emdocs.net]

• Thigh Pain

  She presented with intermittent episodes of groin and thigh pain over a 10-week period. The child had minimal objective findings at the time of each evaluation. Despite the delay in diagnosis, the ovary was preserved. [ncbi.nlm.nih.gov]

• Adnexal Mass

  Important questions regarding medical history include the presence of adnexal mass, gynecologic or obstetric diseases, pregnancy, ongoing infertility treatment, and prior adnexal mass. [emdocs.net]

  Diagnosis can usually be made on the basis of the characteristic clinical presentation in conjunction with ultrasound evidence of a unilaterally enlarged adnexal mass. [casesjournal.biomedcentral.com]

  However, surgeons must note that extensive necrotic tissues in adnexal masses may result in the misdiagnosis of malignancy in frozen section technique. [jmrh.mums.ac.ir]

  Two distinct age groups are identified, the prepubertal or the adolescent age group, where it is mainly idiopathic in nature and in the postmenopausal group due to adnexal masses. [sonoworld.com]

  Pelvic examination revealed a 16-week sized uterus, with a closed cervix, and a tender 10-cm left adnexal mass. Laboratory results were normal. [mdmag.com]

• Adnexal Tenderness

  On pelvic exam, the patient may have adnexal tenderness or an adnexal mass. Fever is uncommon, and usually low-grade if present. Diagnostic Testing The most dangerous condition in the differential for adnexal torsion is an ectopic pregnancy. [cdemcurriculum.com]

  Pelvic inflammatory disease Sexually active female with lower abdominal pain, cervical motion tenderness, and adnexal tenderness. Abnormal vaginal and cervical discharge may be noted, as well as a temperature 101 F ( 38 C). [online.epocrates.com]

  There is adnexal tenderness. A raised white cell count is common. The result of vascular compromise secondary to ovarian torsion is hemorrhagic infarction and necrosis, that can occur as rapidly as within hours of torsion onset. [radiopaedia.org]

  The most common presenting symptom/sign was lower abdominal pains/adnexal tenderness (100%) and none presented with anemia or deranged blood chemistry. Most (66%) had the cyst on the right. [tjogonline.com]

• Imperforate Hymen

  Molar Pregnancy PID Tubo-ovarian Abscess Ovarian Cysts Follicular Cyst Corpus Luteum Cyst Polycystic Ovarian Syndrome Obstructive Genital Lesions Imperforate Hymen Noncommunicating Uterine Horn Endometriosis Associated Chocolate Cyst of Endometriosis [pedclerk.bsd.uchicago.edu]

• Genital Lesions

  Molar Pregnancy PID Tubo-ovarian Abscess Ovarian Cysts Follicular Cyst Corpus Luteum Cyst Polycystic Ovarian Syndrome Obstructive Genital Lesions Imperforate Hymen Noncommunicating Uterine Horn Endometriosis Associated Chocolate Cyst of Endometriosis [pedclerk.bsd.uchicago.edu]

Her subsequent workup suggested AT necessitating a laparoscopic evaluation where right adnexectomy was carried out due to hemorrhagic and necrotic changes. [scitechnol.com]

Abdominal Loin pain hematuria syndrome Proctitis —infection or inflammation of the anus or rectum Colitis —infection or inflammation of the colon Appendicitis —infection or inflammation of the bowel Diagnosis [ edit ] Females [ edit ] The diagnostic workup [en.wikipedia.org]

[…] to and treatment by gynecologic oncologists has been shown to improve survival rates in women with ovarian cancer. 14-16 Cysts with an Indeterminate Likelihood of Malignancy For women with cysts with an intermediate likelihood of malignancy, further workup [clevelandclinicmeded.com]

Ovarian torsion in pregnancy is increasing in frequency due to the growing prevalence of ovarian stimulation treatment. [ncbi.nlm.nih.gov]

[…] long-standing infarcted ovary may have a more complex appearance with cystic or hemorrhagic degeneration Doppler findings in torsion are widely variable 3 little or no intra-ovarian venous flow (common) absent arterial flow (less common, sign of poor prognosis [radiopaedia.org]

Fetal ovarian cysts management and ovarian prognosis: a report of 82 cases. J. Pediatr. Surg. 2009;44:868; author reply 868-9. Guthrie BD, Adler MD, Powell EC. [pemplaybook.org]

Although ovarian torsion in very young children is rare, a case of ovarian cyst torsion was reported in a 2-year-old. [17] Prognosis With early diagnosis and appropriate treatment, the prognosis of ovarian torsion is excellent. [emedicine.medscape.com]

We report the successful management of a prenatally diagnosed ovarian cyst in a newborn female and provide operative evidence for the presumptive etiology of the cyst. [ncbi.nlm.nih.gov]

Etiology and pathophysiology Ovarian torsion is the total or partial rotation of the adnexa around its vascular axis. [mdmag.com]

The objective of this article is to present a case of pediatric ovarian torsion and to review its epidemiology, diagnosis, and treatment. A 3-year-old girl presented to the ED with vomiting, fever, anorexia, and abdominal pain. [ncbi.nlm.nih.gov]

Epidemiology: Ovarian torsion is the fifth most common emergency of the female reproductive organs. Etiology (cause): Sometimes a mass or cyst in the ovary can cause twisting. If the stalk of the ovary is long, it may also lead to torsion. [eapsa.org]

The underlying pathophysiology involves torsion of the ovarian tissue on its pedicle leading to reduced venous return, stromal oedema, internal haemorrhage and infarction with the subsequent sequelae. [ncbi.nlm.nih.gov]

Epidemiology and Pathophysiology Ovarian torsion is the partial or complete twisting of an ovary around its ligamental support, often leading to an occlusion of its blood supply and associated with the sudden onset of abdominal pain and, if untreated, [pedclerk.bsd.uchicago.edu]

[…] of reproductive age, it can occur at any age. [2] Signs and symptoms [ edit ] Patients with ovarian torsion often present with sudden onset of sharp and usually unilateral lower abdominal pain, in 70% of cases accompanied by nausea and vomiting. [6] Pathophysiology [en.wikipedia.org]

Oophoropexy of the ipsilateral and contralateral ovary should be considered to prevent a recurrent torsion. [ncbi.nlm.nih.gov]

The complete absence of flow should be confirmed by power Doppler to prevent erroneous interpretation. 3. In cases of partial/incomplete torsion, intra-ovarian flow may be demonstrated. [sonoworld.com]