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Ovarian torsion

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Four day history of lower abdominal pain and vomiting.

Patient Data

Age: 25 years
Gender: Female
ultrasound

Free fluid with echoes is present in the pelvis.

The left ovary is enlarged, oblong in shape, and hyperechoic. Few small peripheral follicles are present.

No arterial or venous flow is noted.

The right ovary and uterus are normal.

Case Discussion

Findings of an enlarged hyperechoic ovary, peripherally displaced follicles, no intra-ovarian venous flow, free pelvic fluid with echoes favor the diagnosis of ovarian torsion.

Whirlpool sign of a twisted vascular pedicle could not be demonstrated.

No underlying ovarian lesion was found.

Surgery confirmed findings - ovary was not viable.

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