OB/Gyn - Ovarian Torsion
Caption
A 38-year-old female with PMH ulcerative colitis presented with several hour history of RLQ abdominal pain. Pain was described as sharp and constant; it woke her from her sleep. Vitals were WNL. Physical exam was notable for right adnexal tenderness and RLQ abdominal tenderness to palpation. Pelvic ultrasound revealed an enlarged right ovary with peripheralized follicles, heterogenous ovarian stroma, and peri-ovarian free fluid; findings concerning for ovarian torsion. It is important to remember that while ovarian torsion remains a clinical diagnosis, US grey scale findings are some of the most reliable radiographic adjunct predictors of the diagnosis as Doppler imaging often remains normal. Reference: Grunau GL, Harris A, Buckley J, Todd NJ. Diagnosis of Ovarian Torsion: Is It Time to Forget About Doppler? Journal of Obstetrics and Gynaecology Canada. 2018;40(7):871-875. Devin Peuser, @DevinPeuser Brooklyn, NY