gynecology and obstetrics
Adnexal Torsion
Symptoms and Signs of Adnexal Torsion
Adnexal torsion causes sudden, severe pelvic pain and usually nausea and vomiting. For days or occasionally weeks before the sudden pain, some women have intermittent, colicky pain, presumably resulting from intermittent torsion that spontaneously resolves. The pain may be localized to the side with the torsion or may be diffuse. Tachycardia, fever, abdominal tenderness, and peritoneal signs may be present. During pelvic examination, cervical motion tenderness and a unilateral tender adnexal mass are typically present. Pain may be out proportion to examination findings. Peritoneal signs, if present, typically develop later in the course. 