Progressive ovarian enlargement supported surgical intervention, which confirmed the presence of torsion. Initial ultrasound was normal. [Abstract/Free Full Text] Warner MA, Fleischer AC, Edell SL, et al. The torsion of a pedunculated subserous leiomyoma is a rare complication of uterine leiomyoma in pregnancy but should be considered in a pregnant woman with acute onset abdominal pain. Without surgical intervention, the ovary may be lost; therefore, the diagnosis is important. Although this sign is specific for ovarian torsion, yet it had been variably reported as seen in 13–88% of patients with ovarian torsion , , . MRI and ultrasound appearance of ovarian torsion in a 12 week pregnant patient. Graif M, Itzchak Y. Sonographic evaluation of ovarian torsion in childhood and adolescence. A high index of suspicion should be maintained, particularly if there is tenderness or mild swelling of an ovary containing a corpus luteum in early pregnancy. Smorgick N, Pansky M, Feingold M, Herman A, Halperin R, Maymon R. The clinical characteristics and sonographic findings of maternal ovarian torsion in pregnancy. 1 (2): 108-110. Young R, Cork K. Intermittent Ovarian Torsion in Pregnancy. 1 week history of severe left iliac fossa pain. 12 ]. 51 The pelvic ultrasound showed significant enlargement of the left ovary exhibiting a large anechoic cyst with edema of the ovarian stroma and free intraperitoneal fluid effusion. Interestingly, arterial flow with normal waveforms was detected in both the ovary and its pedicle, suggesting either an incomplete torsion, or an element of torsion-detorsion. The incidence of ectopic pregnancy has increased from 0.37% of pregnancies in 1948 to approximately 2% of pregnancies in 1992 (,1). 1 Ovarian torsion … Note that the affected ovary contains the corpus luteum, and this is an established risk factor for torsion in early pregnancy. 1 Torsion more commonly occurs on the right rather than the left with an incidence of 3:2. The … ical evaluation for diagnosing ovarian torsion Ovarian Torsion: Diagnostic Features on CT and MRI With Pathologic Correlation Shauna Duigenan1 Esther Oliva2 Susanna I. Lee1 Duigenan S, Oliva E, Lee SI 1Department of Radiology, Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, Ellison 234, 55 Fruit St, Boston, MA 02114. Radiology 1985;154(3):773–775. O&G - Clinical Conditions - Ovarian - Gynae. Its occurrence during gestation is reported as 2%, accounting for 2.7% of surgical emergencies in pregnant women. Ovarian torsion in pregnancy is increasing in frequency due to the growing prevalence of ovarian stimulation treatment. Early recognition and restoration of blood flow are important to avoid irreversible ovarian damage. Ovarian torsion during pregnancy is an uncommon complication with high fetal mortality if not immediately treated. It can also be seen in pregnancy, but seldom in a normal single pregnancy. Gravid uterus, with a singleton mobile early gestation, not specifically assessed. However, in women presenting with acute pelvic pain, bowel or urologic causes represent the more common causes and will often lead to CT or MRI (the latter in pregnant … It is located in the pouch of Douglas and is enlarged to approximately 50cc. When present, it is often associated with severe pain. It is estimated that about 2.7% of surgical emergencies in women are comprised by ovarian torsion. Unable to process the form. The varied imaging features and nonspecific symptoms of ovarian torsion can lead to a delay in identification, with misdiagnosis being common. Check for errors and try again. Adnexal torsion is commonly unilateral, with a slight (3:2) right-sided predilection (presumably due to the protective effects of the sigmoid colon on the left) 6,8. If not treated quickly, it can result in loss of an ovary. Ultrasound features are consistent with left paraovarian cyst with acute left ovarian torsion and coexisting gravid uterus with normal early pregnancy of 8 weeks. Ovarian torsion is a medical emergency. A corpus luteum is identified within this, as was seen on the preceding ultrasound (not shown). The main feature of torsion is ovarian enlargement due to venous/lymphatic engorgement, edema, and hemorrhage. 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