Ovarian torsion in early pregnancy

Discussion:

MRI and ultrasound appearance of ovarian torsion in a 12 week pregnant patient. Note that the affected ovary contains the corpus luteum, and this is an established risk factor for torsion in early pregnancy. The presence of arterial flow within the ovary suggest either an incomplete torsion, or a torsion-detorsion scenario.  

The delayed presentation (with initial US normal) highlights the difficulty sometimes encountered in making the diagnosis, particularly in the setting of pregnancy, and with intermittent detorsion. A high index of suspicion should be maintained, particularly if there is tenderness or mild swelling of an ovary containing a corpus luteum in early pregnancy.

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