Ovarian torsion

Revision as of 06:28, 3 October 2014 by Rossdonaldson1 (talk | contribs) (Rossdonaldson1 moved page Ovarian Torsion to Ovarian torsion)

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%

DDx

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

Source

  • UpToDate
  • Tintinalli