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Asynchronous Bilateral Ovarian Torsion

  • Jennifer E. Taylor and Richard Spinale
Published/Copyright: June 1, 2017
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 117 Issue 6

Keywords: abdominal pain; ovarian cyst; ovarian torsion

A 43-year-old woman presented to the emergency department with acute right lower quadrant abdominal pain, nausea, and bloating for the past day. Her medical history included a Roux-en-Y gastric bypass procedure 14 years prior. On abdominal examination she had focal guarding in her right lower quadrant. A computed tomographic scan of her abdomen and pelvis showed a multicystic heterogeneous right ovarian mass. Exploratory laparotomy revealed a large right hemorrhagic ovarian cyst with ovarian torsion of the infundibular ligament and vascular pedicle (image A, arrow). She underwent an oophorectomy.

Fifty-four weeks later, she presented to her primary care physician with similar abdominal pain in the left lower quadrant. A computed tomographic scan showed a left ovarian mass (image B, arrow). Exploratory laparotomy revealed 540° torsion of her left ovary, and histologic examination revealed a large left hemorrhagic cyst with torsion. The patient underwent an oophorectomy.

Ovarian torsion can affect women of all ages but rarely occurs in women after menopause.1 It frequently presents as an acute abdomen and thus should be considered in the differential diagnoses in female patients with acute abdominal pain.1 The risk of ovarian torsion is greater for premenopausal women, pregnant women, and women who have hyperstimulated ovaries.1

From the Department of General Surgery at Garden City Hospital in Michigan.
Financial Disclosures: None reported.
Support: None reported.

*Address correspondence to Jennifer E. Taylor, DO, 31941 Augusta Dr, Romulus, MI 48174-6375. E-mail:

Reference

1. Ashwal E , HierschL, KrissiH, et al. Characteristics and management of ovarian torsion in premenarchal compared with postmenarchal patients. Obstet Gynecol. 2015;126(3):514-520. doi:10.1097/AOG.0000000000000995Search in Google Scholar PubMed

Received: 2016-09-02
Accepted: 2016-09-08
Published Online: 2017-06-01
Published in Print: 2017-06-01

© 2017 American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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  8. ORIGINAL CONTRIBUTION
  9. Emergency Health Care Professionals’ Understanding of the Costs of Care in the Emergency Department
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  18. Therapeutic Hypothermia to Treat a Newborn With Perinatal Hypoxic-Ischemic Encephalopathy
  19. Use of the Fascial Distortion Model to Evaluate a Limp in a Child
  20. CLINICAL IMAGES
  21. Asynchronous Bilateral Ovarian Torsion
  22. Abruptio Placentae
https://doi.org/10.7556/jaoa.2017.080
Keywords for this article
abdominal pain; ovarian cyst; ovarian torsion
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. LETTERS TO THE EDITOR
  2. Evaluation of Renal Calculi Passage While Riding a Roller Coaster
  3. CORRECTION
  4. Correction
  5. AOA COMMUNICATION
  6. Official Call: 2017 Annual Business Meeting of the American Osteopathic Association (Reprint)
  7. Proposed Amendments to the AOA Constitution, Bylaws, and Code of Ethics
  8. ORIGINAL CONTRIBUTION
  9. Emergency Health Care Professionals’ Understanding of the Costs of Care in the Emergency Department
  10. BRIEF REPORT
  11. Effects of Osteopathic Manipulative Therapy on Pain and Mood Disorders in Patients With High-Frequency Migraine
  12. REVIEW
  13. One Health: Children, Waterfowl, and Lead Exposure in Northwestern Nigeria
  14. Bridging the Gap: An Osteopathic Primary Care–Centered Approach to Duchenne Muscular Dystrophy
  15. MEDICAL EDUCATION
  16. Osteopathic Medical Students Entering Family Medicine and Attitudes Regarding Osteopathic Manipulative Treatment: Preliminary Findings of Differences by Sex
  17. CASE REPORT
  18. Therapeutic Hypothermia to Treat a Newborn With Perinatal Hypoxic-Ischemic Encephalopathy
  19. Use of the Fascial Distortion Model to Evaluate a Limp in a Child
  20. CLINICAL IMAGES
  21. Asynchronous Bilateral Ovarian Torsion
  22. Abruptio Placentae
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