Cord-like omental entanglement causing right ovarian torsion in an octogenarian woman: a case report.

Cord-like omental entanglement is a rare cause of visceral strangulation, previously reported mainly in bowel obstruction. We report a case in which a cord-like segment of omentum wound once around the utero-ovarian ligament, forming a knot that caused right ovarian torsion in an 80-year-old woman. She presented with a progressively enlarging abdominal mass measuring 100 × 220 mm. Laparotomy revealed omental entanglement with 180-degree torsion of the right ovary. Release of the knot restored blood flow, after which right salpingo-oophorectomy and resection of the cord-like omentum were performed. Histopathologic examination confirmed ischemic changes in a pre-existing ovarian cyst consistent with torsion-induced ischemia. The patient was discharged on postoperative Day 23 and remained well at follow-up. This case indicates that a cord-like omentum can act as an extrinsic trigger of ovarian torsion via a novel mechanism, and that ovarian torsion can occur in elderly women despite its predilection for reproductive-age females.