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An update on the diagnosis and management of ovarian torsion
Author(s) -
Damigos Emmanuel,
Johns Jemma,
Ross Jackie
Publication year - 2012
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1111/j.1744-4667.2012.00131.x
Subject(s) - ovarian torsion , medicine , torsion (gastropod) , oophorectomy , ultrasound , surgical emergency , conservative treatment , radiology , general surgery , surgery , gynecology , hysterectomy
Key content Torsion of the ovary, tube or both is estimated to be responsible for only a small number of all gynaecological emergencies, but is a common diagnostic challenge in the emergency setting. Diagnosis can be difficult and is mainly based on clinical symptoms and imaging techniques such as ultrasound and MRI. A normal ultrasound scan does not exclude adnexal torsion and the decision to operate should be made on clinical grounds if symptoms are severe. Treatment is traditionally surgical removal of the ovary or adnexum, however, there is increasing evidence for conservative surgery, such as de‐torsion and oophoropexy, particularly in younger women. This article provides an overview of the symptomatology, ultrasound diagnosis and classification, as well as treatment options for ovarian torsion.Learning objectives To understand the clinical presentation and ultrasound characteristics associated with ovarian torsion. To review the literature on the available surgical options.Ethical issues Oophorectomy is commonly performed for adnexal torsion with a possible negative impact on fertility in women of reproductive age. De‐torsion is a more conservative surgical approach that should be considered in all younger women with ovarian torsion.