Ovarian Torsion

The ovaries are female reproductive organs that produce eggs. Ovarian torsion is when an ovary becomes twisted and cuts off its own blood supply. This can occur at any age. If an ovary is twisted, it cannot get blood and the ovary swells. It is a painful medical emergency. It must be treated quickly. If too much time has past, blood flow to the ovary may not be restored and the ovary may have to be removed.

CAUSES

Torsion can happen in an ovary that is normal size. However, most of the time it occurs in an ovary that is enlarged. An ovary can become enlarged because of:

  • Harmless (benign) tumors on the ovaries.

  • Cancerous tumors.

  • Ovarian cysts, which are fluid-filled sacs.

  • Normal pregnancy.

  • A pregnancy that occurs outside the uterus (ectopic pregnancy).

RISK FACTORS

Risk factors are things that increase the likelihood of this condition happening. The risk factors include:

  • Having fallopian tubes that are longer than normal.

  • Having ovaries that are larger than normal.

  • Taking fertility medicine to become pregnant.

  • Having had surgery in the pelvic area.

SYMPTOMS

  • Sudden pain in the lower abdomen, usually on one side only.

  • Pelvic pain that starts after exercise.

  • Pelvic pain that gets worse over time.

  • Severe pelvic pain that comes and goes.

  • Pelvic pain that spreads into the lower back or thigh.

  • Nausea and vomiting along with pelvic pain.

DIAGNOSIS

Your caregiver will take a history and perform a physical exam. He or she may be able to feel an enlarged ovary. Your caregiver may order some further tests, which include:

  • A pregnancy test.

  • Imaging tests, such as pelvic Doppler ultrasonography, that measures blood flow, CT scan, or MRI.

Your caregiver may also perform a diagnositic laparoscopic exam. A small surgical cut (incision) will be made in your abdomen. Then, a small lighted telescope is put through the opening. This allows your caregiver to clearly see your ovary and fallopian tube.

TREATMENT

Surgery is needed when an ovary becomes twisted. It is best to do this 8 hours or less after the ovary becomes twisted. Laparoscopic ovarian torsion surgery is done to try to untwist the ovary. Sometimes, a large incision has to be made in the abdomen (laparotomy) to relieve the ovary. If the ovary cannot be untwisted, the ovary will have to be surgically removed during a procedure called salpingo-oophorectomy.