Ovarian torsion: Difference between revisions
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 | ||
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==Clinical Features== | ==Clinical Features== | ||
*Nausea/vomiting | *[[Nausea/vomiting]] (70%) | ||
*Sudden and sharp pain in the lower abdomen | *Sudden and sharp pain in the lower abdomen (59%) | ||
** can be intermittent | ** can be intermittent | ||
*Fever | *[[Fever]] (<2%) | ||
== | ==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 | ||
== | ==See Also== | ||
* | *[[Abdominal pain]] | ||
==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
- Ectopic Pregnancy
- Ruptured or hemorrhagic cyst
- Appendicitis
- PID
- Fibroid (degenerating)
- Endometriosis
- In Vitro fertilization
- Spontaneous AB
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