Summary about Disease
Ovarian torsion is a painful condition that occurs when an ovary twists around the ligaments that hold it in place. This twisting can cut off blood supply to the ovary and fallopian tube. If blood flow is cut off entirely, it can lead to tissue death (necrosis). It is a gynecological emergency that requires prompt diagnosis and treatment to preserve ovarian function.
Symptoms
The primary symptom is sudden, severe lower abdominal pain. This pain often comes and goes (intermittent) initially but may become constant. Other symptoms may include:
Nausea and vomiting
Pain radiating to the back, groin, or thigh
Tenderness in the lower abdomen
Fever (rare)
Abnormal vaginal bleeding
Causes
Ovarian torsion occurs when the ovary twists on its supporting ligaments, compromising blood flow. Factors that can increase the risk of torsion include:
Ovarian cysts or tumors: Enlarged ovaries are more prone to twisting.
Pregnancy: Hormonal changes and increased ovarian size during pregnancy can increase the risk.
Enlarged ovaries due to ovulation induction (fertility treatments)
Prior history of ovarian torsion
Ligament laxity
Medicine Used
While medication may be used for pain management, the primary treatment for ovarian torsion is surgical. Pain medication like NSAIDs or opioids might be administered before surgery. There is no medicine to untwist the ovary; surgery is the definitive treatment.
Is Communicable
No, ovarian torsion is not a communicable disease. It is not caused by an infection and cannot be spread from person to person.
Precautions
There are limited preventative measures for ovarian torsion. However, the following may be considered:
Prompt evaluation of abdominal pain: Seek immediate medical attention for sudden, severe lower abdominal pain.
Careful monitoring during fertility treatments: Close monitoring of ovarian size during ovulation induction can help identify and manage enlarged ovaries.
Discuss risks with your doctor: If you have a history of ovarian torsion or other risk factors, discuss preventative options with your healthcare provider.
How long does an outbreak last?
Ovarian torsion is not an outbreak. It is an individual medical emergency. The event is typically acute, meaning that it has a sudden onset. Treatment aims to resolve the problem within hours of the initial event to prevent permanent damage. If left untreated, the consequences are permanent.
How is it diagnosed?
Diagnosis typically involves:
Pelvic exam: To assess tenderness and identify any masses.
Ultrasound: Transvaginal ultrasound (and sometimes abdominal ultrasound) is often the first-line imaging test to visualize the ovaries and assess blood flow using Doppler.
CT scan or MRI: May be used to further evaluate the ovaries and rule out other conditions, especially if ultrasound findings are unclear.
Laparoscopy: In some cases, a surgical procedure called laparoscopy is needed to confirm the diagnosis and treat the torsion.
Timeline of Symptoms
Sudden onset of severe lower abdominal pain.
Pain may initially be intermittent but usually becomes constant.
Nausea and vomiting may develop shortly after the onset of pain.
If blood flow is not restored promptly, the ovary may become necrotic (tissue death) within hours to days.
Important Considerations
Ovarian torsion is a medical emergency. Prompt diagnosis and treatment are crucial to preserve ovarian function and fertility.
Delayed diagnosis and treatment can lead to ovarian necrosis, requiring removal of the affected ovary (oophorectomy).
Women of reproductive age experiencing sudden, severe lower abdominal pain should seek immediate medical attention.
Even if the ovary appears normal during surgery after being untwisted, observation is important to ensure that blood flow is returning appropriately.
Recurrence of ovarian torsion is possible, even after surgical correction.