Recognition and initial management of ovarian torsion

What you need to knowOvarian torsion is a gynaecological emergency: a delay in diagnosis and referral can lead to a reduction in fertilityOvarian masses are the most common cause of ovarian torsion, but torsion can occur in their absence, including in pregnancy and postpartumOvarian torsion can present without severe pain but instead with more vague symptoms such as isolated nausea and vomitingThe presence of ovarian blood flow on Doppler sonography cannot exclude ovarian torsion and so should not be used to dismiss the diagnosis of torsion in the presence of a suggestive history and clinical examination: seek a senior gynaecological opinion to determine the need for a diagnostic laparoscopyA 35 year old woman presents to her local emergency department with intermittent episodes of severe left iliac fossa pain over a few weeks. The pain is increasing in intensity and associated with vomiting and fainting or dizziness. She is also 10…
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