Management of ovarian torsion: a report of 15 cases

Ovarian torsion is a surgical emergency. Early diagnosis and prompt intervention are required to relieve symptoms and prevent functional loss. Between April, 2008 and May, 2011, 15 instances of surgically treated ovarian torsion were reviewed. All patients presented with lower abdominal pain and most (12/15) had a detectable ovarian mass. Mean age of patients was 35.9±19.4 years (range, 8-79 years), with 46.6±61.9 hours (range, 4.5-198 hours) as the mean interval of time between onset of pain and surgery. Elapsed time was especially lengthy for three of the patients (two premenarchal girls and one elderly woman). In nine cases, absence of enhancement on computed tomographic (CT) scan was viewed as telltale. The patients were evenly divided by operative technique (seven by laparoscopy; eight by laparotomy). Conservative surgery (ie, detorsion and cystectomy) was performed without consequence in six cases. By follow-up sonography, ovaries were of normal size and showed follicular development in four cases. Lack of enhancement on CT is a key finding in ovarian torsion, enabling early diagnosis. In young women with ischemic adnexa, detorsion should be considered as a conservative measure.