eMedicine Specialties > Emergency Medicine > Obstetrics & Gynecology

Ovarian Torsion: Follow-up

Author: Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Coauthor(s): Michelle Blanda, MD, Chair, Department of Emergency Medicine, Summa Health System; Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine
Contributor Information and Disclosures

Updated: Aug 4, 2008

Follow-up

Complications

  • Infection
  • Peritonitis
  • Sepsis
  • Adhesions
  • Chronic pain
  • Infertility (rare)

Prognosis

  • The prognosis is excellent with early diagnosis and appropriate treatment.

Miscellaneous

Medicolegal Pitfalls

  • Failure to consider adnexal torsion in the differential diagnosis is not uncommon given its relative infrequency. Consideration is particularly imperative in a patient with a known ovarian mass or pregnancy.
  • Normal Doppler imaging must not be used as basis for exclusion of the diagnosis.
  • In a patient with a history and physical suggestive of ovarian torsion, gynecologic consultation and subsequent laparoscopy is critical regardless of normal laboratory and radiologic studies.

Special Concerns

  • Pregnancy
    • Approximately 1 in 1800 pregnancies is complicated by adnexal torsion, typically between the sixth and fourteenth weeks of gestation. This increased frequency is likely due to greater laxity of the tissues adjoining the ovaries and oviducts during pregnancy as well as enlargement of the ovary in early pregnancy secondary to the corpus luteum cyst.
    • Detorsion of the adnexa during pregnancy has not been found to compromise to fetal well-being. However, if the corpus luteum cyst is removed during salpingo-oophorectomy, supplemental progesterone is indicated.
  • Postmenopausal women
    • As with other causes of abdominal pain, patients of advanced age are increasingly prone to unusual presentations of ovarian torsion.
    • Adnexal torsion is not limited to women of reproductive age. Ovarian tumors of both benign and malignant nature are common in postmenopausal women and may result in torsion.
  • Children and adolescents: Greater than 50% of patients with torsion in this age group have normal-sized ovaries. In those with indicative histories and absence of alternative diagnoses further investigation must be sought.
 


More on Ovarian Torsion

Overview: Ovarian Torsion
Differential Diagnoses & Workup: Ovarian Torsion
Treatment & Medication: Ovarian Torsion
Follow-up: Ovarian Torsion
References
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References

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Further Reading

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Keywords

adnexal torsion, abdominal pain, ovaries, fallopian tubes, mesosalpinx, ovarian torsion, lower abdominal pain in women, enlarged ovary, ovarian tumor, dermoid tumor, elongated fallopian tube, ovarian enlargement, ovarian cyst

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Contributor Information and Disclosures

Author

Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Disclosure: Nothing to disclose.

Coauthor(s)

Michelle Blanda, MD, Chair, Department of Emergency Medicine, Summa Health System; Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine
Michelle Blanda, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

Jerome FX Naradzay, MD, FACEP, Medical Director, Consulting Staff, Department of Emergency Medicine, Maria Parham Hospital; Medical Examiner, Vance County, North Carolina
Jerome FX Naradzay, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Mark Zwanger, MD, MBA, Assistant Professor, Department of Emergency Medicine, Thomas Jefferson University
Mark Zwanger, MD, MBA is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and American Medical Association
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Pamela L Dyne, MD, Associate Professor, Program Director, Department of Medicine, Division of Emergency Medicine, University of California at Los Angeles School of Medicine
Pamela L Dyne, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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