Ovarian torsion leading to necrosis: A case report

The pathogenesis of ovarian torsion (OT) involves a physical twisting of the ovary on an attachment point that causes lymphatic, venous, and arterial obstruction progressing to ovarian thrombosis, edema, necrosis, and infarction. Ovarian torsion typically involves an ovary with a cyst or tumor, however, this phenomenon can occur in their absence. Ultrasound is the imaging modality of choice for the evaluation and diagnosis of ovarian torsion. Typical features include a unilateral enlarged ovary, uniform peripheral cystic structures, a coexistent mass within the affected ovary, free pelvic fluid, lack of arterial or venous flow, and a twisted vascular pedicle. Management is surgical; however, the specific approach depends on several factors, including the patient’s age, fertility desires, and the presence of underlying ovarian pathology. De-torsion and oophoropexy, rather than oophorectomy, are surgical techniques that are increasing in popularity.