Difference between revisions of "Ovarian torsion"

m (Rossdonaldson1 moved page Ovarian Torsion to Ovarian torsion)
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**Account for only 50% in children (much more likely to torse normal ovaries)
 
**Account for only 50% in children (much more likely to torse normal ovaries)
  
==Pathophysiology==
+
===Pathophysiology===
 
* cysts greater than 4cm more likely to torse
 
* cysts greater than 4cm more likely to torse
 
*dual ovation blood supply so even if flow negative but significant pain still consider as diagnosis
 
*dual ovation blood supply so even if flow negative but significant pain still consider as diagnosis
Line 10: Line 10:
  
 
==Clinical Features==
 
==Clinical Features==
*Nausea/vomiting ~ 70%
+
*[[Nausea/vomiting]] (70%)
*Sudden and sharp pain in the lower abdomen ~ 59%
+
*Sudden and sharp pain in the lower abdomen (59%)
 
** can be intermittent
 
** can be intermittent
*Fever ~ <2%
+
*[[Fever]] (<2%)
  
==DDx==
+
==Differential Diagnosis==
 
*[[Ectopic Pregnancy]]
 
*[[Ectopic Pregnancy]]
 
*Ruptured or hemorrhagic cyst
 
*Ruptured or hemorrhagic cyst
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==Diagnosis==
 
==Diagnosis==
*Ultrasound (sensitivty 46-70%)
+
*[[Ultrasound]] (sensitivty 46-70%)
 
**Diminished or absent blood flow in the ovarian vessels
 
**Diminished or absent blood flow in the ovarian vessels
 
**Ovarian mass
 
**Ovarian mass
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*Emergent OB/GYN consult in ED
 
*Emergent OB/GYN consult in ED
  
==Source==
+
==See Also==
*UpToDate
+
*[[Abdominal pain]]
*Tintinalli
+
 
 +
==References==
  
 
[[Category:OB/GYN]]
 
[[Category:OB/GYN]]

Revision as of 09:36, 1 June 2015

Background

  • Occurs in females of all ages (most common in reproductive age women)
  • Ovarian cysts (usually > 5 mm) and neoplasms account for 94% of cases in adults
    • Account for only 50% in children (much more likely to torse normal ovaries)

Pathophysiology

  • cysts greater than 4cm more likely to torse
  • dual ovation blood supply so even if flow negative but significant pain still consider as diagnosis
    • sonographer should document dual arterial and venous waveforms

Clinical Features

  • Nausea/vomiting (70%)
  • Sudden and sharp pain in the lower abdomen (59%)
    • can be intermittent
  • Fever (<2%)

Differential Diagnosis

Diagnosis

  • Ultrasound (sensitivty 46-70%)
    • Diminished or absent blood flow in the ovarian vessels
    • Ovarian mass
  • Gold standard: direct visualization!

Treatment

  • Emergent OB/GYN consult in ED

See Also

References