gynecology and obstetrics
Adnexal Torsion
Introduction
Adnexal torsion is twisting of the ovary and sometimes the fallopian tube, interrupting the arterial supply and causing ischemia. Symptoms include severe pelvic pain, often with nausea and vomiting. Diagnosis is clinical and with transvaginal ultrasonography. Treatment is usually laparoscopic surgery. Adnexal torsion is one of the most common gynecologic emergencies, occurring most often during reproductive years. It usually occurs when the ovary is enlarged because of a mass or other problem. Prolonged ischemia can cause loss of ovarian function or damage to the fallopian tube. Risk factorsfor adnexal torsion include the following: Ovarian enlargement to>4 cm (particularly by benign tumors) Pregnancy (if a large corpus luteal cyst is present) Induction of ovulation Prior history of adnexal torsion Benign tumors are more likely to cause torsion than malignant ones. Torsion of normal adnexa, which is rare, is more common among children and adolescents than adults ( General reference ). Typically, one ovary is involved, but sometimes the fallopian tube is also involved. Adnexal torsion can cause peritonitis. 