Ovarian (Adnexal) Torsion Questions & Answers

1. Ashwal E, Hiersch L, Krissi H, Eitan R, Less S, Wiznitzer A, et al. Characteristics and Management of Ovarian Torsion in Premenarchal Compared With Postmenarchal Patients. Obstet Gynecol. 2015 Sep. 126 (3):514-20. [QxMD MEDLINE Link].

2. Ashwal E, Krissi H, Hiersch L, Less S, Eitan R, Peled Y. Presentation, Diagnosis, and Treatment of Ovarian Torsion in Premenarchal Girls. J Pediatr Adolesc Gynecol. 2015 Mar 28. [QxMD MEDLINE Link].

3. Ganer Herman H, Shalev A, Ginat S, Kerner R, Keidar R, Bar J, et al. Clinical characteristics of adnexal torsion in premenarchal patients. Arch Gynecol Obstet. 2016 Mar. 293 (3):603-8. [QxMD MEDLINE Link].

4. Koumoutsea EV, Gupta M, Hollingworth A, Gorry A. Ovarian Torsion in the Third Trimester of Pregnancy Leading to Iatrogenic Preterm Delivery. Case Rep Obstet Gynecol. 2016. 2016:8426270. [QxMD MEDLINE Link].

5. Karaman E, Beger B, Çetin O, Melek M, Karaman Y. Ovarian Torsion in the Normal Ovary: A Diagnostic Challenge in Postmenarchal Adolescent Girls in the Emergency Department. Med Sci Monit. 2017 Mar 15. 23:1312-1316. [QxMD MEDLINE Link].

6. Naffaa L, Deshmukh T, Tumu S, Johnson C, Boyd KP, Meyers AB. Imaging of Acute Pelvic Pain in Girls: Ovarian Torsion and Beyond^☆. Curr Probl Diagn Radiol. 2017 Jul - Aug. 46 (4):317-329. [QxMD MEDLINE Link].

7. Asfour V, Varma R, Menon P. Clinical risk factors for ovarian torsion. J Obstet Gynaecol. 2015. 35 (7):721-5. [QxMD MEDLINE Link].

8. Rotoli JM. Abdominal Pain in the Post-menopausal Female: Is Ovarian Torsion in the Differential?. J Emerg Med. 2017 May. 52 (5):749-752. [QxMD MEDLINE Link].

9. Fleischer AC, Stein SM, Cullinan JA, Warner MA. Color Doppler sonography of adnexal torsion. J Ultrasound Med. 1995 Jul. 14(7):523-8. [QxMD MEDLINE Link].

10. Zanforlin Filho SM, Araujo Júnior E, Serafini P, Guimarães Filho HA, Pires CR, Nardozza LM, et al. Diagnosis of ovarian torsion by three-dimensional power Doppler in first trimester of pregnancy. J Obstet Gynaecol Res. 2008 Apr. 34(2):266-70. [QxMD MEDLINE Link].

11. Dhanda S, Quek ST, Mok YT, Rong CYH, Ting YSE, Jagmohan P, et al. CT features in surgically proven cases of ovarian torsion- a pictorial review. Br J Radiol. 2017 May 16. 20170052. [QxMD MEDLINE Link].

12. Guile SL, Mathai JK. Ovarian torsion. StatPearls. [Internet]. Treasure Island, FL: StatPearls Publishing; 2022 Jul 18. [Full Text].

13. Anders JF, Powell EC. Urgency of evaluation and outcome of acute ovarian torsion in pediatric patients. Arch Pediatr Adolesc Med. 2005 Jun. 159(6):532-5. [QxMD MEDLINE Link].

14. Hasson J, Tsafrir Z, Azem F, Bar-On S, Almog B, Mashiach R, et al. Comparison of adnexal torsion between pregnant and nonpregnant women. Am J Obstet Gynecol. 2010 Jun. 202(6):536.e1-6. [QxMD MEDLINE Link].

15. Chang HC, Bhatt S, Dogra VS. Pearls and pitfalls in diagnosis of ovarian torsion. Radiographics. 2008 Sep-Oct. 28(5):1355-68. [QxMD MEDLINE Link].

16. Livingston JK, Gonzales S, Langdorf MI. Computed tomography appearance of the "whirlpool sign" in ovarian torsion. Clin Pract Cases Emerg Med. 2021 Nov. 5 (4):468-9. [QxMD MEDLINE Link].

17. Baradwan S, Sendy W, Sendy S. Bilateral dermoid ovarian torsion in a young woman: a case report. J Med Case Rep. 2018 Jun 8. 12 (1):159. [QxMD MEDLINE Link]. [Full Text].

18. Bider D, Mashiach S, Dulitzky M, Kokia E, Lipitz S, Ben-Rafael Z. Clinical, surgical and pathologic findings of adnexal torsion in pregnant and nonpregnant women. Surg Gynecol Obstet. 1991 Nov. 173(5):363-6. [QxMD MEDLINE Link].

19. Griffin D, Shiver SA. Unusual presentation of acute ovarian torsion in an adolescent. Am J Emerg Med. 2008 May. 26(4):520.e1-3. [QxMD MEDLINE Link].

20. Huang TY, Lau BH, Lin LW, Wang TL, Chong CF, Chen CC. Ovarian cyst torsion in a toddler. Am J Emerg Med. 2009 Jun. 27(5):632.e1-3. [QxMD MEDLINE Link].

21. Fleischer AC, Brader KR. Sonographic depiction of ovarian vascularity and flow: current improvements and future applications. J Ultrasound Med. 2001 Mar. 20(3):241-50. [QxMD MEDLINE Link].

22. Lee EJ, Kwon HC, Joo HJ, Suh JH, Fleischer AC. Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. J Ultrasound Med. 1998 Feb. 17(2):83-9. [QxMD MEDLINE Link].

23. Koonings PP, Grimes DA. Adnexal torsion in postmenopausal women. Obstet Gynecol. 1989 Jan. 73(1):11-2. [QxMD MEDLINE Link].

24. Xiang H, Han J, Ridley WE, Ridley LJ. Snail shell sign: Testicular/ovarian torsion. J Med Imaging Radiat Oncol. 2018 Oct. 62 Suppl 1:106. [QxMD MEDLINE Link]. [Full Text].

25. Peña JE, Ufberg D, Cooney N, Denis AL. Usefulness of Doppler sonography in the diagnosis of ovarian torsion. Fertil Steril. 2000 May. 73(5):1047-50. [QxMD MEDLINE Link].

26. Smorgick N, Pansky M, Feingold M, Herman A, Halperin R, Maymon R. The clinical characteristics and sonographic findings of maternal ovarian torsion in pregnancy. Fertil Steril. 2009 Dec. 92(6):1983-7. [QxMD MEDLINE Link].

27. Auslender R, Shen O, Kaufman Y, Goldberg Y, Bardicef M, Lissak A, et al. Doppler and gray-scale sonographic classification of adnexal torsion. Ultrasound Obstet Gynecol. 2009 Aug. 34(2):208-11. [QxMD MEDLINE Link].

28. Mashiach R, Melamed N, Gilad N, Ben-Shitrit G, Meizner I. Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. J Ultrasound Med. 2011 Sep. 30(9):1205-10. [QxMD MEDLINE Link].

29. Grunau GL, Harris A, Buckley J, et al. Diagnosis of ovarian torsion: is it time to forget about Doppler?. J Obstet Gynaecol Can. 2018 Jul. 40 (7):871-5. [QxMD MEDLINE Link].

30. Kimura I, Togashi K, Kawakami S, Takakura K, Mori T, Konishi J. Ovarian torsion: CT and MR imaging appearances. Radiology. 1994 Feb. 190(2):337-41. [QxMD MEDLINE Link].

31. Siegelman ES, Outwater EK. Tissue characterization in the female pelvis by means of MR imaging. Radiology. 1999 Jul. 212(1):5-18. [QxMD MEDLINE Link].

32. Van Kerkhove F, Cannie M, Op de Beeck K, Timmerman D, Pienaar A, Smet MH, et al. Ovarian torsion in a premenarcheal girl: MRI findings. Abdom Imaging. 2007 May-Jun. 32(3):424-7. [QxMD MEDLINE Link].

33. Oyama K, Nakamoto K, Omori M, et al. Prognostication of ovarian function after ovarian torsion using intraoperative indocyanine green angiography. J Minim Invasive Gynecol. 2022 Feb. 29 (2):237-42. [QxMD MEDLINE Link].

34. Kawakami K, Murata K, Kawaguchi N, Furukawa A, Morita R, Tenzaki T, et al. Hemorrhagic infarction of the diseased ovary: a common MR finding in two cases. Magn Reson Imaging. 1993. 11(4):595-7. [QxMD MEDLINE Link].

35. MacDuff R, Anthony GS, MacLennan AC. Ovarian torsion diagnosed by MRI. J Obstet Gynaecol. 2007 Oct. 27(7):743-4. [QxMD MEDLINE Link].

36. Bekci T, Cakir IM, Aslan S. Differentiation of affected and nonaffected ovaries in ovarian torsion with magnetic resonance imaging texture analysis. Rev Assoc Med Bras (1992). 2022 May. 68 (5):641-6. [QxMD MEDLINE Link].

37. Shadinger LL, Andreotti RF, Kurian RL. Preoperative sonographic and clinical characteristics as predictors of ovarian torsion. J Ultrasound Med. 2008 Jan. 27(1):7-13. [QxMD MEDLINE Link].

38. Gittleman AM, Price AP, Goffner L, Katz DS. Ovarian torsion: CT findings in a child. J Pediatr Surg. 2004 Aug. 39(8):1270-2. [QxMD MEDLINE Link].

39. Duigenan S, Oliva E, Lee SI. Ovarian torsion: diagnostic features on CT and MRI with pathologic correlation. AJR Am J Roentgenol. 2012 Feb. 198(2):W122-31. [QxMD MEDLINE Link].

40. Moore C, Meyers AB, Capotasto J, Bokhari J. Prevalence of abnormal CT findings in patients with proven ovarian torsion and a proposed triage schema. Emerg Radiol. 2009 Mar. 16(2):115-20. [QxMD MEDLINE Link].

41. Cano Alonso R, Borruel Nacenta S, Díez Martínez P, María NI, Ibáñez Sanz L, Zabía Galíndez E. Role of multidetector CT in the management of acute female pelvic disease. Emerg Radiol. 2009 Nov. 16(6):453-72. [QxMD MEDLINE Link].

42. Lam A, Nayyar M, Helmy M, Houshyar R, Marfori W, Lall C. Assessing the clinical utility of color Doppler ultrasound for ovarian torsion in the setting of a negative contrast-enhanced CT scan of the abdomen and pelvis. Abdom Imaging. 2015 Oct. 40 (8):3206-13. [QxMD MEDLINE Link].

43. Li D, Zhang J, Kiryu S, et al. Clinical and CT features of ovarian torsion in infants, children and adolescents. Int J Gynaecol Obstet. 2022 Mar. 156 (3):444-9. [QxMD MEDLINE Link].

44. Soh PQ, Cheng C, Reddington C, et al. Oophorectomy for ovarian torsion - should this be abandoned?. Aust N Z J Obstet Gynaecol. 2022 Aug. 62 (4):548-52. [QxMD MEDLINE Link].

45. Gozukucuk M, Karasu Y, Kaya SM, et al. Conventional versus single-incision laparoscopy for the surgical treatment of ovarian torsion. J Minim Access Surg. 2022 Apr-Jun. 18 (2):207-11. [QxMD MEDLINE Link].

46. Adams K, Ballard E, Amoako A, et al. When is it too late? Ovarian preservation and duration of symptoms in ovarian torsion. J Obstet Gynaecol. 2022 May. 42 (4):675-9. [QxMD MEDLINE Link].

47. [Guideline] Bhosale PR, Javitt MC, Atri M, Harris RD, Kang SK, Meyer BJ, et al. ACR Appropriateness Criteria® Acute Pelvic Pain in the Reproductive Age Group. Ultrasound Q. 2016 Jun. 32 (2):108-15. [QxMD MEDLINE Link]. [Full Text].

48. [Guideline] Kives S, Gascon S, Dubuc É, Van Eyk N. No. 341-Diagnosis and Management of Adnexal Torsion in Children, Adolescents, and Adults. J Obstet Gynaecol Can. 2017 Feb. 39 (2):82-90. [QxMD MEDLINE Link]. [Full Text].

49. Asfour V, Varma R, Menon P. Clinical risk factors for ovarian torsion. J Obstet Gynaecol. 2015 Aug 19. 1-5. [QxMD MEDLINE Link].

Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

Arthur C Fleischer, MD Professor, Chief of Ultrasound Imaging, Cornelius Vanderbilt Chair, Departments of Radiology and Obstetrics and Gynecology, Vanderbilt University Medical Center

Arthur C Fleischer, MD is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, Society of Radiologists in Ultrasound

Disclosure: Nothing to disclose.

Eugene C Lin, MD Attending Radiologist, Teaching Coordinator for Cardiac Imaging, Radiology Residency Program, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine

Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, Society of Nuclear Medicine and Molecular Imaging

Disclosure: Nothing to disclose.

Michelle Blanda, MD Chair, Department of Emergency Medicine, Summa Health System Akron City/St Thomas Hospital; 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.

Harris L Cohen, MD, FACR Chairman, Department of Radiology, Professor of Radiology, Pediatrics, and Obstetrics and Gynecology, University of Tennessee Health Science Center College of Medicine; Medical Director, Department of Radiology, LeBonheur Children's Hospital; Emeritus Professor of Radiology, The School of Medicine at Stony Brook University

Harris L Cohen, MD, FACR is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, Association of Program Directors in Radiology, Radiological Society of North America, Society for Pediatric Radiology, and Society of Radiologists in Ultrasound

Disclosure: Nothing to disclose.

Pamela L Dyne, MD Professor of Clinical Medicine/Emergency Medicine, University of California, Los Angeles, David Geffen School of Medicine; Attending Physician, Department of Emergency Medicine, Olive View-UCLA Medical Center

Pamela L Dyne, MD 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.

Karen L Reuter, MD, FACR Professor, Department of Radiology, Lahey Clinic Medical Center

Karen L Reuter, MD, FACR is a member of the following medical societies: American Association for Women Radiologists, American College of Radiology, American Institute of Ultrasound in Medicine, American Roentgen Ray Society, and Radiological Society of North America

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Mark Zwanger, MD, MBA Assistant Professor, Department of Emergency Medicine, Jefferson Medical College of 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.

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