What should you know?
Ovarian torsion occurs when the ovary twists around its supporting vessels and compromises blood flow. It is an emergency in which rapid assessment improves the chance of preserving ovarian tissue.
Risk rises with an ovarian cyst or enlarged ovary, pregnancy and ovulation stimulation. Intermittent twisting can cause episodes that temporarily improve.
Common symptoms and signs
- Sudden severe one-sided pelvic or lower abdominal pain
- Nausea and vomiting
- Marked tenderness or recurrent attacks
- Known ovarian cyst or recent stimulation
Diagnosis and the role of ultrasound
Ultrasound assesses ovarian enlargement, edema, follicle distribution, cysts, free fluid and Doppler flow. Normal arterial flow does not completely exclude torsion when symptoms are convincing.
- Enlarged edematous ovary
- Peripheral follicles
- Venous and arterial flow
- Possible twisted vascular pedicle
Treatment and next steps
High clinical suspicion requires immediate gynecologic or surgical review. Definitive diagnosis and treatment are often laparoscopic; temporary pain relief does not rule torsion out.
When is urgent care needed?
- Sudden one-sided pain with nausea or vomiting
- Severe pain with a known ovarian cyst
- Pain during pregnancy or after fertility stimulation