Ovarian torsion; early diagnosis by MRI to prevent irreversible damage.

BACKGROUND

Early diagnosis of ovarian torsion can help prevent irreversible damage to the adnexal structures in women desiring to maintain fertility.

CASE: The patient was transferred by ambulance for a six-hour history of severe lower abdominal pain. Magnetic resonance imaging (MRI) revealed bilateral enlarged ovaries measuring 5 x 6 cm (right) and 4 x 5 cm (left) with a right twisted and thickened peduncle. Ultrasonography failed to detect the peduncle changes. At surgery, the right adnexa was twisted 180 degrees in a clockwise direction with no findings suggestive of gangrenous change, hemorrhagic infarction or ischemic change. Detorsion of the twisted ovary was performed.

CONCLUSION

Detection of tube torsion at MRI may be useful in the preoperative evaluation for surgical detorsion of twisted adnexa encountered in enlarged ovaries.