Seldom, our cores tie themselves in knots. An unusual serious condition known as ovarian torsion which is also known as adnexal torsion befalls when the ovary, and sometimes the fallopian tube, flip on the tissues that support them. This cuts off the blood supply to the ovary, which if not handled quickly, can cause tissue in the organ to deteriorate.
Diagnosing ovarian torsion in the emergency department is a hurdle. Any female patient who displays abdominal pain should urge consideration of torsion in ED providers. While the overall incidence of ovarian torsion is weak and there is almost no associated fatality, when avoided, ovarian torsion might result in a notable degree of morbidity for the patient and medicolegal peril for the provider.
To reduce the danger of missing a case of ovarian torsion, we shall include numerous important deadfalls and mistakes related to the workup of inherent torsion.
What is Ovarian Torsion?
Ovarian torsion is a disease that occurs due to the ovary twists around the ligaments that hold it in position. This twisting may lead to cutting off blood flow to the ovary and fallopian tube. Ovarian torsion can cause relentless pain and other symptoms because the ovary is not getting enough blood. If the blood confinement stays for too long, it can lead to tissue death.
The ovaries, which are about the size and shape of an almond, are usually positioned in a woman’s uterus, one on each side. The ovaries have two principal functions: generating hormones ( estrogen and progesterone) and delivering an egg each month for implantation.
Although ovarian torsion is rare, still it is a medical emergency. Surgery will be required to untwist or get rid of the ovary. If the blood supply is cut off for a long period, the ovary might no longer be able to do its regular work, which could affect pregnancy and create other problems. But, the good news is that if tackled immediately, women have a great chance of making a full medical recovery.
Symptoms of a flipped ovary
The indications of a flipped ovary appear abruptly and intensely. They consist of critical pain in the pelvic region, as well as nausea and vomiting. The unforeseen pain is often led by specific cramps for numerous days, or sometimes, for weeks (oftentimes because the ovary turns and untwists frequently).
Doctors suggest that everyone has a complex pain outset, especially if they have other pain syndromes or things that could be influencing them. Please note that with this condition, typically, you figure out that something is not right and you need to seek medical attention. Rather, this can be a challenging diagnosis to make as some ailments, for example, kidney stones or diverticulitis might also give you pelvic pain.
How do we treat Ovarian Torsion?
Surgery is the only method to tackle ovarian torsion. If there is a sore, the surgeon will first get rid of it, and then untwist the ovary and/or fallopian tube, which will reinstate proper blood flow.
There are two procedures commonly used:
- Laparoscopy: Surgeons make a few tiny holes in your belly to implant a laparoscope which is a thin tube with a camera and light at the tip and surgical instruments to remove a sore (if it is required) and untwist the ovary and, if necessitated, the fallopian tube. After they are ensured that there is blood flow to the ovary, the surgery is finished. This could be done in the hospital under anesthesia and does not need a late stay.
- Laparotomy: A bigger hole is made in the abdomen so that surgeons can see the afflicted organs and untwist the ovary (and remove a sore, if it is present). the surgeon will then sew up the hole. This needs staying overnight in the hospital as the healing from an open surgery will take longer.
People who are between the ages of twenty and forty years old are most likely to be affected by ovarian torsion. However, it is not necessary as women of all ages, from infancy to post-menopause, can be trapped in the claws of ovarian torsion.
Seldom, the presence of a sore or other tissue mass in the ovary can remove it. The additional burden or mass on the ovary can induce it to start to twist and turn around its supporting ligaments.
Another general cause is an ovarian ligament, connecting the ovary to the uterus, which is longer than normal. A longer ovarian ligament can most likely cause ovarian torsion.
Assisted reproductive technologies (ART), like inducing ovulation, are another agents that will develop the danger for ovarian torsion.
Pregnant women might undergo ovarian torsion as well as the ones who are not pregnant. In their first trimester, women might have corpus luteum blisters that make the ovary twist.
Higher hormone levels throughout pregnancy can also relax tissues in the body, including the ligaments that keep the ovaries in the correct position. If the ligaments are not tight, they can be more prone to flipping.
When to see a doctor
It is necessary to try medical care if a woman has any of the symptoms of ovarian torsion. To diagnose ovarian torsion, a surgeon might use the following tests:
- A transvaginal ultrasound, that includes implanting a small ultrasound probe into the vagina.
- An abdominal ultrasound, which practices an ultrasound probe on the outline of the stomach.
- Other imaging tests including, a CT scan or MRI scan.
- A whole blood count test, or CBC, can estimate the number of white blood cells in your body.
However, a surgeon cannot fully verify the ovarian torsion without performing surgery to see the ovary.