Difference between revisions of "Ovarian torsion"

(Differential Diagnosis)
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==Differential Diagnosis==
 
==Differential Diagnosis==
*[[Ectopic Pregnancy]]
+
{{Abd DDX RLQ}}
*Ruptured or hemorrhagic cyst
+
 
*[[Appendicitis]]
+
{{LLQ DDX}}
*[[PID]]
 
*Fibroid (degenerating)
 
*Endometriosis
 
*In Vitro fertilization
 
*Spontaneous AB
 
  
 
==Diagnosis==
 
==Diagnosis==

Revision as of 10:05, 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

RLQ Pain

LLQ Pain

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