Ovarian Torsion

Essential Information about Ovarian Torsion

Twisting of the ovary and/or fallopian tube with risk of obstructing venous and arterial blood allowance.

Frequently, but not always, linked with ovarian cyst.

Clinical Presentation

Acute pelvic pain, nausea, and vomiting; pain may come in waves if having intermittent torsion

Occurs more in ages 7 to 11.

More common on the right side than left; may mimic acute appendicitis.

Diagnosis and Evaluation

Pelvic ultrasound may show echogenic mass within the ovary.

“String of pearls” appearance caused by peripheral ovarian follicles (note that the term string of pearls is also used to describe polycystic ovarian syndrome (PCOS), which is unrelated to torsion).

Doppler studies may show reduced blood flow.


Urgent involvement of gynecology or pediatric surgery to detorse ovary with focus on conservation of the ovary.

Ovarian cystectomy if cyst involvement.

Prophylactic oophoropexy of the contralateral ovary should be considered to reduce risk of future ovarian torsion.

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