Presentation
Acute onset right iliac fossa pain
Patient Data
Normal size, anteverted uterus without myometrial or endometrial anormality.
Both ovaries are normal in size and appearance. Both are mobile and non-tender and ovarian vascularity was demonstrated bilaterally.
However in the right adnexal region, there is a thickened tubular structure which is twisted, giving a "whirlpool" appearance - highly suspicious for tubal torsion. Adjacent to this (and clearly separate from the right ovary), there is an anechoic structure measuring 3.4 x 7.0 x 3.8 cm which lies in close proximity to the medial uterine tube on the right.
There is a small amount of free fluid with low level echoes in this region.
The appendix is normal.
Case Discussion
At surgery, tubal torsion was confirmed. There was an associated parafimbrial cyst, which likely acted as a lead point for torsion. The right ovary was confirmed to be normal.
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