Ovarian torsion
Revision as of 15:58, 24 October 2013 by Ostermayer (talk | contribs)
Background
- Occurs in females of all ages (most common in reproductive age women)
- Ovarian cysts (usually > 5 mm) and neoplasms account for 94% of cases in adults
- Account for only 50% in children (much more likely to torse normal ovaries)
Clinical Features
- Nausea/vomiting ~ 70%
- Sudden and sharp pain in the lower abdomen ~ 59%
- can be intermittent
- Fever ~ <2%
DDx
- Ectopic Pregnancy
- Ruptured or hemorrhagic cyst
- Appendicitis
- PID
- Fibroid (degenerating)
- Endometriosis
- In Vitro fertilization
- Threatened Ab
Diagnosis
- Ultrasound (sensitivty 46-70%)
- Diminished or absent blood flow in the ovarian vessels
- Ovarian mass
- Gold standard: direct visualization!
Treatment
- Emergent OB/GYN consult in ED
Source
- UpToDate
- Tintinalli