N83.5

Clinical Causes: Presence of ovarian cysts or tumors, which can increase the weight and mobility of the ovary Rapid growth or enlargement of ovarian tissues Anatomic abnormalities that allow excessive mobility of the ovary or fallopian tube Pregnancy, which can alter pelvic anatomy and promote torsion Previous pelvic or ovarian surgery, leading to adhesions and increased risk Hormonal influences that cause ovarian enlargement

Key Symptoms: Sudden, severe pelvic or abdominal pain, often on one side Nausea and vomiting concurrently with pain episodes Tenderness upon pelvic examination Abdominal swelling or bloating Fever, in case of associated infection or complication Irregular menstrual cycles or bleeding in some cases

Diagnosis Path: Diagnosing torsion involves a combination of clinical evaluation and imaging techniques. Healthcare providers typically perform a pelvic exam to assess tenderness and masses. Ultrasound imaging, especially transvaginal ultrasound, is the preferred initial test to visualize the ovaries, fallopian tubes, and any cysts or masses. Doppler ultrasound may evaluate blood flow; reduced or absent flow suggests torsion. Additional imaging studies like MRI can be utilized if necessary. Laboratory tests may support diagnosis but are generally not definitive.

Treatment Protocols: Treatment often involves prompt surgical intervention to untwist or remove the affected tissues. Laparoscopy is the preferred minimally invasive approach, allowing direct visualization and management of the twisted structures. During surgery, the surgeon may decide to untwist (detorse) the ovary and fallopian tube if they appear viable or remove them if they are necrotic. Postoperative care involves pain management and monitoring for complications. Early detection and treatment are crucial to preserve fertility and prevent further damage.