Clinical Case Database / Category: Patient Management

Ovarian torsion - a gynaecological emergency

Publication details

Dr Hajeb Kamali, Professor David Cahill, Dr Qassem Shehab
Foundation Years Journal, volume 8, issue 7, p.76 (123Doc Education, London, July 2014)

Abstract

A 31 year old female attends the emergency department with a 7-hour history of severe right sided pelvic pain. She reports a constant crampy background ache with intermittent waves of stabbing pain lasting minutes at a time, which she rates at 10/10 in severity. She also reports new onset nausea and has vomited twice.

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Authors

Dr Hajeb Kamali

School of Obstetrics and Gynaecology
Severn Deanery
Health Education South West
Severn Postgraduate Medical Education
Deanery House Unit D - Vantage Business Park
Old Gloucester Road
Bristol, BS16 1GW
hajeb.kamali@doctors.org.uk

Professor David Cahill

Professor Of Reproductive Medicine & Medical
University Hospitals Bristol NHS Foundation trust
Gynaecology outpatients
St Michael’s Hospital
Southwell Street
Bristol, BS2 8EG
Education
d.j.cahill@bristol.ac.uk

Dr Qassem Shehab

Obstetrics & Gynaecology Specialist Registrar, Severn Deanery
School of Obstetrics & Gynaecology
Severn Deanery
Health Education South West
Severn Postgraduate Medical Education
Deanery House Unit D - Vantage Business Park
Old Gloucester Road, Bristol, BS16 1GW
qassemshehab@yahoo.com

References

1. Hibbard LT. Adnexal torsion. Am J Obstet Gynecol 1985, 152:456
2. Bouguizane S, Bibi H, Farhat Y, et al. Adnexal torsion: a report of 135 cases. J Gynecol Obstet Biol Reprod (Paris) 2003, 32:535
3. Houry D, Abbott JT. Ovarian torsion: a fifteen – year review. Ann Emerg Med 2001, 38:156
4. Oltmann SC, Fischer A, Barber R, et al. Cannot exclude torsion – a 15 year review. J Pediatr Surg 2009, 44:1212 Pansky M, Smorgick N, Herman A, et al. Torsion of normal adnexa in postmenarchal women and risk of recurrence. Onstet Gynecol 2007, 109:355
6. Daponte A, Pournaras S, Hadjuchristodoulou C, et al. Novel serum inflammatory markers in patients with adnexal mass who had surgery for ovarian torsion. Fertil Steril 2006, 85:1469
7. Bar-On S, Mashiach R, Stockheim D, et al. Emergency laparoscopy for suspected ovarian torsion: are we too hasty to operate? Fertil Steril 2010, 93:2012
8. Think 8 is the same as 7
9. Huchon C, Staraci S, Fauconnier A. Adnexal torsion: a predictive score for pre-operative diagnosis. Hum Reprod 2010, 25:2276
10. Gynaecology.co. Ovarian torsion http://www.gynaecology.co/conditions/ova riancysts/
ovariantorsion.html
11. Department of radiology, Virginia Commonwealth University medical center. Case of the week: March 7-March14, 2013 http://www.pedsradiology.com/His toryanswer.aspx?qid=503&fid=1
12. Ovary disease. Ovarian Torsion. http://www.ovarydisease.com/p/ovarian-torsion.html
13. Aziz D, Davis V, Allen L, Langer JC. Ovarian torsion in children: is oophorectomy necessary? J Pediatr Surg 2004; 39:750.
14. Oelsner G, Bider D, Goldenberg M, et al. Long-term follow-up of the twisted ischemic adnexa managed by detorsion. Fertil Steril 1993; 60:976.
15. Oelsner G, Cohen SB, Soriano D, et al. Minimal surgery for the twisted ischaemic adnexa can
preserve ovarian function. Hum Reprod 2003; 18:2599.
16. Taskin O, Birincioglu M, Aydin A, et al. The effects of twisted ischaemic adnexa managed by
detorsion on ovarian viability and histology: an ischaemia-reperfusion rodent model. Hum Reprod 1998; 13:2823.
17. Crouch NS, Gyampoh B, Cutner AS, Creighton SM. Ovarian torsion: to pex or not to pex? Case report and review of the literature. J Pediatr Adolesc Gynecol 2003; 16:381.
18. Ozcan C, Celik A, Ozok G, et al. Adnexal torsion in children may have a catastrophic sequel:
asynchronous bilateral torsion. J Pediatr Surg 2002; 37:1617.

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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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