Written by Medicover Team and Medically Reviewed by Dr Afshaan Shaik, Gynecologist

Ovarian Torsion: Symptoms, Causes, Diagnosis & Treatment

Ovarian torsion is a serious gynecological emergency that occurs when an ovary twists around the ligaments that support it, cutting off its blood supply. Often associated with ovarian cysts, this condition can lead to severe pain and, if not treated promptly, permanent damage to the ovary or fallopian tube.

This guide explores ovarian torsion symptoms, causes, risk factors, diagnostic techniques like ultrasound and radiology and essential treatment options to help patients and caregivers better understand this condition.

What Is Ovarian Torsion?

Ovarian torsion, sometimes referred to as a twisted ovary or torcao ovary (in Portuguese), is a condition in which the ovary rotates around the ligaments that hold it in place. This twisting obstructs blood flow to the ovary, potentially causing tissue damage or ovarian necrosis if not addressed in time.

Ovarian torsion typically occurs in one ovary but can affect either side. It is more common in women of reproductive age but may also occur in adolescents, during pregnancy, or even post-menopause in rare cases.

Ovarian Torsion Symptoms

Recognizing ovarian torsion symptoms early is crucial for timely medical intervention. The condition often mimics other abdominal or pelvic issues, making diagnosis challenging without imaging.

Common Symptoms Include:

If these symptoms occur suddenly or intensify, it is essential to seek emergency medical care.

Ovarian Torsion Causes

The primary ovarian torsion causes often involve structural or physiological factors that make the ovary more mobile or enlarged.

Common Causes:

1. Ovarian Cysts or Masses: A large or heavy ovarian cyst can shift the balance of the ovary, increasing the chance of torsion. In such cases, it may be referred to as ovarian cyst torsion.
2. Pregnancy: Hormonal changes during pregnancy, especially in the first trimester, can lead to enlarged ovaries and torsion.
3. Fertility Treatments: Procedures like ovarian stimulation for IVF can increase ovarian size, raising the risk of torsion.
4. Congenital Abnormalities: Longer ligaments or anatomical variations can make the ovaries more prone to twisting.

Diagnosis: Ovarian Torsion Radiology and Ultrasound

Proper diagnosis is vital to prevent irreversible damage to the ovary. Clinical symptoms alone may not be conclusive, so imaging studies are used for confirmation.

Ovarian Torsion Ultrasound

Transvaginal ultrasound with Doppler flow is the most common and effective tool for diagnosing ovarian torsion. It helps visualize the ovary’s size, position and blood flow.

Ovarian Torsion Radiology

In cases where ultrasound is inconclusive MRI or CT scans can provide more detailed imaging, especially when the diagnosis needs to rule out other abdominal conditions like appendicitis or ectopic pregnancy.

Treatment for Ovarian Torsion

Ovarian torsion is a surgical emergency. Prompt treatment increases the chance of saving the ovary.

Surgery Options

If the ovary is found to be nonviable (necrotic), oophorectomy (removal of the ovary) may be necessary. However, many cases are resolved successfully without removal, especially if treated early.

Can Ovarian Torsion Be Prevented?

While not always preventable, certain measures can help reduce the risk:

Women who have experienced ovarian torsion once may be at higher risk for recurrence and doctors may recommend preventive procedures like ovarian fixation in some cases.

Ovarian Torsion in Special Populations

In Children and Adolescents:

Pediatric ovarian torsion often presents with non-specific abdominal pain, making diagnosis more difficult. Rapid assessment and surgery are key to preserving fertility.

During Pregnancy:

Ovarian torsion is more common during the first trimester. Laparoscopic surgery can usually be performed safely during pregnancy.

Complications if Left Untreated

If ovarian torsion is not diagnosed and treated quickly, it can result in:

Early detection and timely treatment significantly reduce these risks.

Conclusion

Ovarian torsion is a medical emergency that requires prompt diagnosis and treatment to prevent long-term complications. Understanding the symptoms of ovarian torsion, it is potential causes, and diagnostic tools like ultrasound and radiology can lead to faster medical intervention.

If you or someone you know experiences sudden pelvic pain, do not delay. Consult a gynaecologist or visit the emergency department immediately. With early intervention, the outcomes are often positive, and ovarian function can be preserved.

Frequently Asked Questions