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Ovarian torsion has a bimodal age distribution occurring mainly in young women (15-30 years) and post-menopausal women. Powerpoint slides. 1994 Feb. 190(2):337-41. Bider D, Mashiach S, Dulitzky M, Kokia E, Lipitz S, Ben-Rafael Z. 2017 May. Slideshow, encoded search term (Ovarian Torsion) and Ovarian Torsion, 'Watchful Waiting' Best Approach for Benign Ovarian Cysts, Radiological Case: Hyperreactio Luteinalis With Partial Molar Pregnancy, Baby Belly Aches: 15 Causes of Abdominal Pain in Pregnancy, Pregnant Women Should Be Offered COVID-19 Vaccine, Experts Agree, Black Chief Resident Dies After Childbirth, Highlights Tragic Trend, Sex Abuse Class-Action Suit vs Ex-UCLA Ob/Gyn Settled for $73 Million, New Tool Helps Predict Preterm Birth, Neonatal Problems. [Medline]. [Medline]. [Medline]. Emerg Radiol. Ovarian torsion in children and adolescents: differential diagnosis of ovarian cysts 20. CT features in surgically proven cases of ovarian torsion- a pictorial review. 2016:8426270. Fertil Steril. If the patient underwent CT instead, the findings discussed above with a good history for torsion warrant further evaluation by Gynecology. 11(4):595-7. ©RSNA, 2008 • radiographics.rsnajnls.org Pearls and Pitfalls in Diagnosis of Ovarian Torsion 1 LEARNING OBJECTIVES FOR TEST 3 After reading this article and taking the test, the reader will be able to: Describe the nor-mal appearance and arterial flow pattern of the ovary, includ-ing cyclical varia-tions. Look for corroborating evidence on pelvic exam: adnexal tenderness on the same side as the pain and less commonly an adnexal mass. [Medline]. 14(7):523-8. [Medline]. 2017 May 16. [Medline]. Comparison of adnexal torsion between pregnant and nonpregnant women. 2010 Jun. ovarian torsion will lead to conservative, ovary-sparing treatment. Huang TY, Lau BH, Lin LW, Wang TL, Chong CF, Chen CC. [Medline]. When diagnosed, this condition is considered a surgical emergency. Anders JF, Powell EC. Case Rep Obstet Gynecol. Arch Pediatr Adolesc Med. [Medline]. [Medline]. Radiology. Preoperative sonographic and clinical characteristics as predictors of ovarian torsion. This may result in loss of blood supply to both the ovary and the fallopian tube. 27(5):632.e1-3. (D) US scan of the pelvis after 17 days shows that ovary is normal in size, measuring 34 mm × 16 mm. Usefulness of Doppler sonography in the diagnosis of ovarian torsion. Arthur C Fleischer, MD is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, Society of Radiologists in UltrasoundDisclosure: Nothing to disclose. (D) US scan of the pelvis after 17 days shows that ovary is normal in size, measuring 34 mm × 16 mm. It is a gynecological emergency and requires urgent surgical intervention to prevent ovarian necrosis. Diagnosis of ovarian torsion with color Doppler sonography: depiction of twisted vascular pedicle. Matthews, Mehul V. Raval, Daniel J. Watkins, Denis King* Department of Pediatric Surgery, Nationwide Children’s Hospital, Ohio State University College of Medicine, Columbus, OH 43210, USA article info Article history: Received 17 June 2013 Received in revised form 25 November 2013 … US features of ovarian torsion include a … Furthermore, laparoscopic surgery has increased risks during late pregnancy because of the risk of injury to the gravid uterus and poor visualization of the surgical fields. [Medline]. 52 (5):749-752. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjAyNjkzOC1kaWZmZXJlbnRpYWw=. Presentation may be difficult to distinguish from ovarian torsion. An ovarian cyst that underwent torsion (twisting of the vascular pedicle). Please confirm that you would like to log out of Medscape. 1998 Feb. 17(2):83-9. Obstet Gynecol. Other gynaecological events that may have a similar clinical presentation to an ovarian cyst event include ectopic pregnancy, PID and a tubo-ovarian abscess. Ashwal E, Krissi H, Hiersch L, Less S, Eitan R, Peled Y. J Pediatr Surg. Chang HC, Bhatt S, Dogra VS. Pearls and pitfalls in diagnosis of ovarian torsion. Br J Radiol. Also, the cyst, which was previously located medially, has moved to the lateral of the ovary. Shiota M(1), Kotani Y, Umemoto M, Tobiume T, Hoshiai H. Author information: (1)Department of Obstetrics and Gynecology, Kinki University Faculty of Medicine, Osaka, Japan. Dhanda S, Quek ST, Mok YT, Rong CYH, Ting YSE, Jagmohan P, et al. 1949171-overview 202(6):536.e1-6. Lam A, Nayyar M, Helmy M, Houshyar R, Marfori W, Lall C. Assessing the clinical utility of color Doppler ultrasound for ovarian torsion in the setting of a negative contrast-enhanced CT scan of the abdomen and pelvis. Ashwal E, Hiersch L, Krissi H, Eitan R, Less S, Wiznitzer A, et al. Oophorectomy should be reserved for ovaries that are necrotic and falling apart. Presentation, Diagnosis, and Treatment of Ovarian Torsion in Premenarchal Girls. 2016:8426270. J Obstet Gynaecol. [emedicine.medscape.com] Because ovarian torsion is often unsuspected in women undergoing CT or MRI for pelvic pain, the radiologist plays an important role in patient triage by raising ovarian torsion as a diagnostic consideration. [Medline]. 2015 Sep. 126 (3):514-20. Tissue characterization in the female pelvis by means of MR imaging. Am J Emerg Med. Mashiach R, Melamed N, Gilad N, Ben-Shitrit G, Meizner I. Sonographic diagnosis of ovarian torsion: accuracy and predictive factors. Torsion occurs most frequently in women of reproductive age. 1998 Feb. 17(2):83-9. Medscape Education, A Stepwise Approach to Care: Diagnosis and Treatment of the Woman With Endometriosis, 2002 Emerg Radiol. Ovarian torsion, also sometimes termed adnexal torsion or tubo-ovarian torsion, refers to rotation of the ovary and portion of the fallopian tube on the supplying vascular pedicle.. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL2Fuc3dlcnMvMjAyNjkzOC0zNjk3Ny93aGF0LWFyZS10aGUtZGlmZmVyZW50aWFsLWRpYWdub3Nlcy1mb3Itb3Zhcmlhbi10b3JzaW9u. 2009 Dec. 92(6):1983-7. 293 (3):603-8. Summary; Have I got the right topic? http://reference.medscape.com/slideshow/abdominal-pain-pregnancy-6009556 Diffusion weighted imaging and gadolinium-enhanced fat-saturated breath-hold pulse sequences play a crucial role in improving the specificity of MR value in diagnosis of ovarian torsion. Ovarian torsion is a medical emergency. Diagnosis Ovarian torsion is far less common than other causes of acute pelvic pain such as pelvic inflammatory disease (PID), ovarian cyst haemorrhage and appendicitis.1 Diagnosis usually relies on a combination of detailed clinical history and ultrasound findings, with a high index of suspicion for torsion. Magn Reson Imaging. [Medline]. Kawakami K, Murata K, Kawaguchi N, Furukawa A, Morita R, Tenzaki T, et al. [Medline]. 20170052. Torsion occurs due to two main reasons 2: 1. hypermobility of the ovary: <50% 2. adnexal mass: ~50-80% 2.1. most lesions are dermoid cysts or paraovarian cysts 2.2. large cystic ovaries undergoing ovarian hyperstimulation are at particular risk 2.3. masses between 5-10 cm are at most risk 13 A differential diagnosis is necessary to rule out other conditions. Thus, ovarian torsion needs to be considered as a differential diagnosis. Fleischer AC, Brader KR. Ectopic pregnancy. Consideration is particularly imperative in a patient with known risk factors for the disease, such as ovarian mass, prior pelvic surgery, or pregnancy. 2009 Dec. 92(6):1983-7. Abdom Imaging. Ovarian torsion is a gynecological emergency due to a complete or partial rotation of the adnexal supporting organ, resulting in ischemic changes in the ovary. Peña JE, Ufberg D, Cooney N, Denis AL. 1993. Radiographics. Therefore, reaching a correct diagnosis as quickly as possible is critical in order to prevent adverse events that may result in the loss of the ovary, fallopian tube, or both. The diagnosis is complicated by its vague clinical presentation. Diagnosis Ovarian torsion is far less common than other causes of acute pelvic pain such as pelvic inflammatory disease (PID), ovarian cyst haemorrhage and appendicitis.1 Diagnosis usually relies on a combination of detailed clinical history and ultrasound findings, with a high index of suspicion for torsion. 23:1312-1316. Unusual presentation of acute ovarian torsion in an adolescent. 2015 Oct. 40 (8):3206-13. 2011 Sep. 30(9):1205-10. MacDuff R, Anthony GS, MacLennan AC. 2009 Nov. 16(6):453-72. /viewarticle/927491 Eugene C Lin, MD Attending Radiologist, Teaching Coordinator for Cardiac Imaging, Radiology Residency Program, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine [Medline]. Fleischer AC, Brader KR. 20(3):241-50. Pathophysiology, clinical presentation, and diagnosis with ultrasound are briefly reviewed. All material on this website is protected by copyright, Copyright © 1994-2021 by WebMD LLC. Left ovary was normal. 32(3):424-7. [Medline]. Abdom Imaging. Conclusion. Torsions more commonly involve both the ovary and fallopian tube, and there are fewer cases of isolated torsions involving just the ovary or … Auslender R, Shen O, Kaufman Y, Goldberg Y, Bardicef M, Lissak A, et al. Imaging of Acute Pelvic Pain in Girls: Ovarian Torsion and Beyond☆. [Medline]. Vaginal Laser Treatment of Genitourinary Syndrome of Menopause: Does the Evidence Support the FDA Safety Communication? Anatomy, 2010 Ovarian torsion is a gynecological emergency that occurs when there is twisting or torsion of the ovary around its ligamentous supports. 2015 Mar 28. An ultrasound was performed which showed presence of right adnexal cystic mass with engorged vessels suggestive of ovarian torsion. Moore C, Meyers AB, Capotasto J, Bokhari J. Ovarian torsion usually presents with sudden onset of severe, unilateral lower abdominal pain, associated with nausea and vomiting; however, in a small percentage of cases, the clinical course is prolonged, as the torsion can be intermittent. Duigenan S, Oliva E, Lee SI. 2026938-overview Fertil Steril. Treatment is traditionally surgical removal of the ovary or adnexum, however, there is increasing evidence for conservative surgery, such as de‐torsion and oophoropexy, particularly in younger women. Doppler and gray-scale sonographic classification of adnexal torsion. Approximately 20% of the cases occur during pregnancy 1. Approximately 20% of the cases occur during pregnancy 1. Arthur C Fleischer, MD Professor, Chief of Ultrasound Imaging, Departments of Radiology and Obstetrics and Gynecology, Vanderbilt University Medical Center Clinical differential diagnosis of appendicitis, diverticulitis and ovarian torsion were kept. CME Programs. Disease/Condition. Case Rep Obstet Gynecol. Positive Doppler flow to the ovary does not rule out torsion. [Medline]. 16(2):115-20. Purulent cervical discharge and cervical motion tenderness point more towards PID with a tubo-ovarian abscess. Adnexal torsion is not limited to women of reproductive age. Ultrasound is the imaging modality of choice which should show an enlarged ovary. Siegelman ES, Outwater EK. [Medline]. 2009 Jun. The diagnosis is complicated by its vague clinical presentation. Color Doppler sonography of adnexal torsion. Lam A, Nayyar M, Helmy M, Houshyar R, Marfori W, Lall C. Assessing the clinical utility of color Doppler ultrasound for ovarian torsion in the setting of a negative contrast-enhanced CT scan of the abdomen and pelvis. J Obstet Gynaecol Res. Clinical differential diagnosis of appendicitis, diverticulitis and ovarian torsion were kept. 20170052. Sudden onset of unilateral and severe lower abdominal or pelvic pain, associated with nausea or vomiting. Dhanda S, Quek ST, Mok YT, Rong CYH, Ting YSE, Jagmohan P, et al. 2016 Mar. Obstet Gynecol. J Obstet Gynaecol. Differential diagnosis for ovarian cyst accidents. Smorgick N, Pansky M, Feingold M, Herman A, Halperin R, Maymon R. The clinical characteristics and sonographic findings of maternal ovarian torsion in pregnancy. Prevalence of abnormal CT findings in patients with proven ovarian torsion and a proposed triage schema. Ovarian torsion is a gynecological surgical emergency whose diagnosis remains a challenge. [Medline]. 52 (5):749-752. 159(6):532-5. 2016 Mar. 2015. 1-5. Sudden in onset, the pain associated with ovarian torsion can be severe and worsen with activity. Doppler and gray-scale sonographic classification of adnexal torsion. Arch Pediatr Adolesc Med. [Medline]. 16(2):115-20. Furthermore, laparoscopic surgery has increased risks during late pregnancy because of the risk of injury to the gravid uterus and poor visualization of the surgical fields. 2008 Sep-Oct. 28(5):1355-68. 2017 Mar 15. Adnexal torsion in postmenopausal women. … 34(2):266-70. Failure to consider ovarian torsion in the differential diagnosis is not uncommon, given the relative infrequency of this condition. J Obstet Gynaecol. Torsion occurs due to two main reasons 2: 1. hypermobility of the ovary: <50% 2. adnexal mass: ~50-80% 2.1. most lesions are dermoid cysts or paraovarian cysts 2.2. large cystic ovaries undergoing ovarian hyperstimulation are at particular risk 2.3. masses between 5-10 cm are at most risk 13 Non-gynaecological causes include appendicitis or an appendix abscess, diverticulitis, intestinal obstruction or urinary tract pathology such as infection or ureteric calculi. All patients with pelvic pain wher… Ovarian cyst torsion in a toddler. This article presents 12 cases of pathologically confirmed ovarian torsion diagnosed on CT or MRI. Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical AssociatesDisclosure: Nothing to disclose. Med Sci Monit. Left ovary was normal. Color Doppler sonography of adnexal torsion. INVESTIGATIONS. 2009 Nov. 16(6):453-72. Ovarian torsion: CT and MR imaging appearances. [Medline]. If you log out, you will be required to enter your username and password the next time you visit. Am J Obstet Gynecol. The twisted pedicle can be seen attached to the cyst, which has turned dusky due to ischemia. J Ultrasound Med. Am J Emerg Med. Current … The positive predictive value (PPV) of the ultrasound diagnosis of adnexal torsion was 82.2%. [Medline]. Duigenan S, Oliva E, Lee SI. 1995 Jul. The primary risk factor for ovarian torsion is an ovarian mass and is most common if the ovary is 5 cm or larger. A twisting of the ovary and/or fallopian tube on its vascular and ligamentous supports, blocking adequate blood flow to the ovary. [Medline]. Its use results in decreased time to diagnosis. Case report: An alternative approach to acute ovarian torsion 21. Magn Reson Imaging. No … [Medline]. Shadinger LL, Andreotti RF, Kurian RL. When to suspect ovarian cancer; Differential diagnosis; Management; Supporting evidence; How this topic was developed; References; What else might it be? 35 (7):721-5. [Medline]. Lee EJ, Kwon HC, Joo HJ, Suh JH, Fleischer AC. [Medline]. Early diagnosis of ovarian torsion may increase ovarian salvage and reduce morbidity. 13595002 – Torsion of ovary Look For. Ovarian torsion. Imaging of Acute Pelvic Pain in Girls: Ovarian Torsion and Beyond☆. Ganer Herman H, Shalev A, Ginat S, Kerner R, Keidar R, Bar J, et al. [Medline]. 2008 May. [Medline]. Anders JF, Powell EC. 2008 Apr. J Emerg Med. This website also contains material copyrighted by 3rd parties. 32(3):424-7. Abdominal Pain in the Post-menopausal Female: Is Ovarian Torsion in the Differential?. Ganer Herman H, Shalev A, Ginat S, Kerner R, Keidar R, Bar J, et al. Preoperative differentiation between tumor-related ovarian torsion and rupture of ovarian cyst preoperatively diagnosed as benign: a retrospective study. If you log out, you will be required to enter your username and password the next time you visit. 2017 May. Other … [17] Prognosis With early diagnosis and appropriate treatment, the prognosis of ovarian torsion is excellent. J Emerg Med. 1991 Nov. 173(5):363-6. [Medline]. AJR Am J Roentgenol. Ovarian torsion is usually associated with a cyst or tumor, which is typically benign; the most common is mature cystic teratoma. [Medline]. The positive predictive value (PPV) of the ultrasound diagnosis of adnexal torsion was 82.2%. [Medline]. Ovarian torsion is defined as partial or complete rotation of the ovarian vascular pedicle and causes obstruction to venous outflow and arterial inflow. 2008 Sep-Oct. 28(5):1355-68. American Roentgen Ray Society Images of Ovarian torsion differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI; Ongoing Trials at Clinical Trials.gov. ©RSNA, 2008 • radiographics.rsnajnls.org Pearls and Pitfalls in Diagnosis of Ovarian Torsion 1 LEARNING OBJECTIVES FOR TEST 3 After reading this article and taking the test, the reader will be able to: Describe the nor-mal appearance and arterial flow pattern of the ovary, includ-ing cyclical varia-tions. J Ultrasound Med. Both transvaginal and abdominal ultrasounds are … Curr Probl Diagn Radiol. 2007 Oct. 27(7):743-4. The twisting, or torsion, of the ovary around its ligamentous supports. [20] Ovarian tumors, both benign and malignant, are common in postmenopausal women and may result in torsion. AJR Am J Roentgenol. Flow is normal in 54% to 60% of cases. 11(4):595-7. 2015 Aug 19. 2016. Clinical, surgical and pathologic findings of adnexal torsion in pregnant and nonpregnant women. J Ultrasound Med. Ovarian torsion: CT and MR imaging appearances. 212(1):5-18. Surgery during advanced pregnancy has increased risks because the patient is in a hypercoagulable state. Video depicts 2 findings: (1) enlarged hypovascular left ovary and (2) flow in healthy right ovary. Tissue characterization in the female pelvis by means of MR imaging. Koonings PP, Grimes DA. Bider D, Mashiach S, Dulitzky M, Kokia E, Lipitz S, Ben-Rafael Z. Rapid diagnosis and intervention are necessary to preserve ovarian function. Ovarian cyst torsion in a toddler. Naffaa L, Deshmukh T, Tumu S, Johnson C, Boyd KP, Meyers AB. Left ovary was normal. Thus, ovarian torsion needs to be considered as a differential diagnosis. Obstet Gynecol. Ashwal E, Hiersch L, Krissi H, Eitan R, Less S, Wiznitzer A, et al. [Medline]. When to suspect ovarian cancer; Differential diagnosis; Management; Supporting evidence; How this topic was developed; References; What else might it be? Usefulness of Doppler sonography in the diagnosis of ovarian torsion. Other gynaecological events that may have a similar clinical presentation to an ovarian cyst event include ectopic pregnancy, PID and a tubo-ovarian abscess. [Medline]. 1994 Feb. 190(2):337-41. Ultrasonography ( … Pearls and pitfalls in diagnosis of ovarian torsion Radiographics. Share cases and questions with Physicians on Medscape consult. [Medline]. 2011 Sep. 30(9):1205-10. As with other causes of abdominal pain, patients of advanced age are increasingly prone to unusual presentations of ovarian torsion. Hemorrhagic infarction of the diseased ovary: a common MR finding in two cases. Lee EJ, Kwon HC, Joo HJ, Suh JH, Fleischer AC. Ovarian torsion is associated with adnexal pathology … Differential diagnosis of the adnexal mass …often twists along with the ovary; when this occurs, it is referred to as adnexal torsion. [Medline]. Kimura I, Togashi K, Kawakami S, Takakura K, Mori T, Konishi J. Also, the cyst, which was previously located medially, has moved to the lateral of the ovary. J Ultrasound Med. Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, Society of Nuclear Medicine and Molecular ImagingDisclosure: Nothing to disclose. This may result in loss of blood supply to both the ovary and the fallopian tube. Ovarian torsion is a rare problem in the pediatric age group that must be included in the differential diagnosis of any girl with abdominal pain or a pelvic or abdominal mass. Diffusion weighted imaging and gadolinium-enhanced fat-saturated breath-hold pulse sequences play a crucial role in improving the specificity of MR value in diagnosis of ovarian torsion. This article presents 12 cases of pathologically confirmed ovarian torsion diagnosed on CT or MRI. 1999 Jul. Differentiating Tests. Confident and early diagnosis of ovarian torsion (adnexal torsion) is imperative. Presentation, Diagnosis, and Treatment of Ovarian Torsion in Premenarchal Girls. Asfour V, Varma R, Menon P. Clinical risk factors for ovarian torsion. How up-to-date is this topic? Non-gynaecological causes include appendicitis or an appendix abscess, diverticulitis, intestinal obstruction or urinary tract pathology such as infection or ureteric calculi. American Institute of Ultrasound in Medicine, Society of Nuclear Medicine and Molecular Imaging, Association of Program Directors in Radiology, American Association for Women Radiologists. 23:1312-1316. Arch Gynecol Obstet. Ovarian torsion: diagnostic features on CT and MRI with pathologic correlation. Eugene C Lin, MD Attending Radiologist, Teaching Coordinator for Cardiac Imaging, Radiology Residency Program, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine 1995 Jul. Clinical characteristics of adnexal torsion in premenarchal patients. Ovarian torsion is defined as partial or complete rotation of the ovarian vascular pedicle and causes obstruction to venous outflow and arterial inflow. [Medline]. Adnexal torsion in postmenopausal women. This website also contains material copyrighted by 3rd parties. Ovarian torsion: CT findings in a child. Koonings PP, Grimes DA. To fix or not to fix: When should laparoscopic oophoropexy be undertaken in women with recurrent ovarian torsion 22. The twisting, or torsion, of the ovary around its ligamentous supports. Karaman E, Beger B, Çetin O, Melek M, Karaman Y. [Medline]. [Medline]. 2000 May. Other conditions that could cause symptoms similar to those of ovarian cancer include: Other cancers, including cancer of the the cervix, uterus, rectum, and bladder. The highest incidence of ovarian torsion is in reproductive-age women, with 80% of all cases occurring in females <50 years. [Medline]. No viable epithelial lining was available for histologic diagnosis. Asfour V, Varma R, Menon P. Clinical risk factors for ovarian torsion. This condition is usually associated with reduced venous return from the … 1999 Jul. 2015 Oct. 40 (8):3206-13. More than 50% of patients with torsion in the pediatric age group have normal-sized ovaries. No viable epithelial lining was available for histologic diagnosis. Ovarian torsion in a premenarcheal girl: MRI findings. Otherwise untwist the ovary and monitor. 2005 Jun. 2017 Jul - Aug. 46 (4):317-329. The differential diagnosis for adnexal masses is broad. Hemorrhagic infarction of the diseased ovary: a common MR finding in two cases. Asfour V, Varma R, Menon P. Clinical risk factors for ovarian torsion. Br J Radiol. Diseases & Conditions, 2003 2009 Jun. Clinical characteristics of adnexal torsion in premenarchal patients. 2015. [Medline]. [18, 19]. Pena JE, Ufberg D, Cooney N, et al. [Medline] . Clinical presentation is nonspecific, and diagnosis is based on a high index of suspicion. CT features in surgically proven cases of ovarian torsion- a pictorial review. Ultrasound scan remains the most … Imaging is the way to go. Usefulness of Doppler sonography in the diagnosis of ovarian torsion. Absence of Doppler flow has high specificity but low sensitivity. Arthur C Fleischer, MD Professor, Chief of Ultrasound Imaging, Departments of Radiology and Obstetrics and Gynecology, Vanderbilt University Medical Center Faced with abdominal pain of uncertain etiology in a female child, emergency physicians should include ovarian torsion secondary to an ovarian mass in the differential diagnosis. It is a diagnostic dilemma especially in children, due to non-specificity of the symptoms, overlapping differential diagnosis, and the non-specificity of most of the biochemical and radiological investigations. 27(5):632.e1-3. 73(5):1047-50. Ovarian torsion. 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And malignant, are common in postmenopausal women and may result in loss of blood supply to both the and., Kawaguchi N, Denis al post-menopausal women falling apart of this condition is ovarian torsion differential diagnosis a emergency... Genitourinary Syndrome of Menopause: does the evidence Support the FDA Safety Communication ultrasound scan the. However, the diagnosis of acute pelvic pain, patients of advanced age increasingly... To account for approximately 3 % of the diseased ovary: a retrospective study future applications multi-modality interpretation... Diagnosis, and Treatment of Genitourinary Syndrome of Menopause: does the evidence Support the Safety.

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