Ovarian Torsion (Emergency Medicine)

00:01 We’re gonna move on and talk about ovarian torsion.

00:04 So ovarian torsion is essentially that the ovary has twisted upon its blood supply and it’s not getting good blood supply.

00:11 Now, the ovary is a little bit unique in the sense that it gets dual blood supply.

00:15 So it gets blood supply from two different locations.

00:17 So sometimes, if just one of them is twisted, that that potentially may not have as serious implications for the patient and also due to the dual blood supply when the condition is resolved, those patients oftentimes have better outcomes than in testicular torsion where they just have that singular blood supply.

00:37 Now, it’s twisting of the ovary and oftentimes, the fallopian tube as well.

00:42 Initially, what happens is just a venous and lymphatic obstruction, and then eventually as the condition progresses, the arteries can be affected.

00:52 Ovarian torsion is most common in women of reproductive age and this is due to the menstrual cycle and formation of the corpus luteum cyst, because as you get an ovarian cyst, the ovary will grow in size and as the ovary grows in size, it can have a tendency to twist upon itself.

01:11 So you can imagine having someone or something that’s a little bit off balance that can cause it to twist.

01:17 It’s more common in ovaries that are greater than 5 cm and more common also with benign ovarian tumors or cysts.

01:26 It’s also important to remember that it’s more common on the right more than the left adnexa because the left adnexa is further stabilized by the sigmoid colon which is basically just adjacent to it and that causes the left adnexa to be a little bit more fixed in position.

01:43 It can also be associated with infertility treatment and for the most part, that’s due to the fact that when patients are undergoing infertility treatment, their ovary rather can enlarge and it can twist upon itself.

01:55 The classic history for this is sudden onset of pain in the lower abdomen, severe lower abdominal pain, oftentimes, there’s associated nausea and vomiting and you wanna ask about any recent infertility treatments.