The findings were correlated with the surgical and pathologic findings of the affected ovaries and tumors. Case Reports in Obstetrics and Gynecology. Ultrasonography findings suggestive of ovarian torsion include unilateral ovarian enlargement, ovarian edema characterized by the presence of a hyperechogenic ovary with peripherally displaced follicles and echogenic stroma, free fluid, and a coiled vascular pedicle (referred to as the “whirlpool sign”) 17 Figure 2. However, heightened awareness and suspicion of this condition are needed for timely intervention. An ultrasound of a patient with abdominal pain might reveal abnormally positioned ovaries, masses or ovarian enlargement. Pediatric synchronous bilateral ovarian torsion: a case report and review of the literature. Servaes S, Zurakowski D, Laufer MR, Feins N, Chow JS. A and B, Two types of target appearances of the twisted vascular pedicle (arrows). A. Early recognition and restoration of blood flow are important to avoid irreversible ovarian damage. The Journal of Obstetrics and Gynecology of India. Video 2 — To‐and‐fro movement of the probe along the axis of the twisted pedicle in the color Doppler mode showing the whirlpool sign of the visualized artery and vein. Unable to process the form. Pediatr. Ultrasound Evaluation of Gynecologic Causes of Pelvic Pain. • Ovarian torsion 4. A, Twisted pedicle appearing as a large echogenic mass (arrows). 2010;36:630-4. Pathologic diagnosis of the ovarian masses in the 19 patients in whom the ovarian mass was removed included teratoma in 6, serous cystadenoma in 4, mucinous cystadenoma in 2, a luteal cyst in 3, fibroma in 1, and hemorrhagic necrosis of the ovary in 2. The ovary was swollen but appeared viable. A Rare Case of Nine Twisted Adnexal Torsion Successfully Resolved by Conservative Laparoscopic Detorsion. Preoperative CT image-based assessment for estimating risk of ovarian torsion in women with ovarian lesions and pelvic pain. A palpable pelvic mass was reported in 10 patients, and it was found to be tender in 5. Twisted pedicle appearing as a large hypoechoic mass (arrows). If not treated quickly, it can result in loss of an ovary. Methods. and you may need to create a new Wiley Online Library account. Ultrasound of Pelvic Pain in the Nonpregnant Woman. Nontraumatic Abdominal Pain in Pregnancy: Imaging Considerations for a Multiorgan System Problem. Obstetric and Gynecologic Ultrasound: Case Review Series. Absence of blood flow in the twisted pedicle and visualization of the flow in the artery alone are predictive of nonviability of the ovary. To describe an additional maneuver during sonography for ovarian torsion and to assess its diagnostic value. A positive whirlpool sign in the twisted vascular pedicle of the ovary is the most definitive sign of ovarian torsion. Rosen's Emergency Medicine – Concepts and Clinical Practice. Torsión ovárica secundaria a teratoma maduro de ovario, causa infrecuente de dolor abdominal agudo. Sonographic and MRI features of ovarian torsion. The whirlpool sign is a more definitive indicator of torsion. Acute abdominal distension in early pregnancy from torted ovarian serous cystadenoma. Hemorrhagic infarction of the ovary or a mass was present in all the patients in whom no blood flow was seen in the pedicle. The artery alone was seen in 6 patients. During a period of about 2 years 6 months, 21 patients with acute or intermittent lower abdominal pain who had an ovarian mass and an extraovarian mass suggestive of a twisted vascular pedicle on sonography were studied. Epub 2007 Mar 15. Emergent Ultrasound for Evaluation of Female Pelvic Pain. On MRI, it is best demonstrated on axial T2 and T1 C+ fat sat sequences 1. 31 Tepper R, Zalel Y, Goldberger S, Cohen I, Markov S, Beyth Y. Conclusions. Although this sign is specific for ovarian torsion, yet it had been variably reported as seen in 13–88% of patients with ovarian torsion , , . Epithelial Stromal Tumors: Serous and Mucinous (Clinical Setting and Ultrasound). The whirlpool sign is visualized by moving the ultra- sound probe back and forth along the axis of suspected torsion(eitheralongtheovarianligament,whentorsionof 2007;37:446-51. The ovarian mass in others appeared as a unilocular cyst in 3 patients, a multiseptated cyst in 3, solid and cystic in 2, and solid in 2. Case 246: MR Imaging of a Complex Cystic Mass in a Newborn Girl. If you do not receive an email within 10 minutes, your email address may not be registered, Adnexal torsion is reported to be the fifth most common gynecologic emergency condition encountered, with a prevalence of 2.7%.1 Prompt diagnosis and surgery may prevent irreversible adnexal damage. Case Report: Ovarian Torsion in Pregnancy – Diagnosis and Management. Significant elevation in serum CA 125 and CA 19-9 levels with torsion of the hydrosalpinx in a postmenopausal woman. Gynecological pelvic pain as emergency pathology. This is similar to the whirlpool sign described with caudal movement of the probe in malrotation of the midgut with volvulus.1213 The diagnosis of ovarian torsion is made only when this whirlpool sign is seen. Imaging of Female Children and Adolescents with Abdominopelvic Pain Caused by Gynecological Pathologies. It is difficult to distinguish these findings from those of other diseases, such as hemorrhagic cysts, endometriosis, ovarian masses, pelvic inflammatory disease, and ectopic pregnancy.145 Previous reports suggested that the presence of a unilateral enlarged ovary with multiple peripherally located follicles might be a specific finding for ovarian torsion, with a detection rate of 64%, but this feature was not always observed.57 In this series, 1 of these gray scale features of torsion was seen in only 7 patients. Among the 6 patients in whom the artery alone was seen, 4 had impending gangrene, and the ovary was removed. Neonatal Surgery for Giant Floating Abdominal Cysts in Females: Clinical and Surgical Management. Female Genital Anomalies and Important Ovarian Conditions. It was tender in 5 patients. Laparoscopic Adnexal Detorsion in a 20-Week Pregnant Patient: A Case Report and Literature Review. Dolor pélvico de origen ginecológico como patología urgente. Number of times cited according to CrossRef: How to perform a gynaecological ultrasound in the paediatric or adolescent patient. Point-of-Care Pelvic Ultrasonography in Emergency Medicine. {"url":"/signup-modal-props.json?lang=us\u0026email="}. Laparoscopic Adnexectomy for Ovarian Torsion during Late Pregnancy: Case Report of a Non-Conservative Treatment and Literature Analysis. 1. The movement of the probe during the color Doppler study also highlighted the whirlpool sign of wrapping of the visualized vessels around the central axis. In this article, we discuss and illustrate the normal appearance and arterial flow … Treatment. Diagnostic Dilemma in a 75-Year-Old Woman Presenting with Acute Pain in Her Abdomen. The gray scale features of the ovarian mass were recorded. Ovarian torsion is the fifth most common gynecologic surgical emergency (,1). Because she showed improvement, she did not undergo surgery. Venous blood flow disappears first, then arterial. Ovarian torsion is caused by rotation of the ovary or adnexa with the vascular pedicle on its axis, resulting in arterial, venous, or lymphatic obstruction. The ovary or the mass was viable in all the patients who showed flow in both the artery and the vein. Video 1 — To‐and‐fro movement of the probe along the axis of the twisted pedicle showing the whirlpool sign in gray scale. There was an enlarged ovary with peripheral cysts suggestive of ovarian torsion in 5. The visualized ovarian artery and vein were observed to be winding around the central axis (Video 2). Lee et al11 also reported 94% predictability of the viability of the ovary when arterial and venous flow was seen in the twisted pedicle. In 2 patients with cystic masses, the wall was thick, suggestive of torsion. In 2 patients, the artery alone was seen in the proximal part of the pedicle, and it too was absent in the distal part (Figure 6 and Table ). It appears as twisting of the thickened vascular pedicle of the enlarged ovary. In all of them, the whirlpool sign (Video 1) was seen when the transducer was moved to and fro along the central axis of the twisted pedicle. BL‐indicates urinary bladder; and CYST, ovarian cyst. Fourteen of them had acute severe pain, and 7 had intermittent pain. The whirlpool sign can be seen on ultrasound by moving the probe along the axis of the suspected torsion. Magnetic Resonance Imaging Clinics of North America. J Ultrasound Med 2004; 23(12): 1643–1649. Tératomes ovariens matures et immatures : caractéristiques en échographie, TDM et IRM. Its location and gray scale features were noted, and an additional maneuver was carried out. During a period of about 2 years 6 months, there were 21 patients with lower abdominal pain who had an ovarian mass and an extraovarian mass suggestive of a twisted vascular pedicle on sonography. Acute Pelvic Pain in Premenapausal Women, Children and Infants: Evidence-Based Emergency Imaging. The ovary can also show multiple cortical follicles. If there is evidence of blood flow, especially if blood flow is present in the interior of the ovary, it does not exclude torsion but may suggest that a viable ovary exists. Crossref, Medline, Google Scholar; 32 Vijayaraghavan SB. Usefulness of ultrasonography in children with right iliac fossa pain. Obstetrics & Gynecology International Journal. Journal of Medical Imaging and Radiation Oncology. Seeing past the appendix: the role of ultrasound in right iliac fossa pain. 2. Sonographic findings of ovarian torsion in children. The ultrasonic whirlpool sign combined with plasma d-dimer level in adnexal torsion. Administering opiate analgesics B. Laparotomy C. Serial abdominal exams Emergency Medicine Clinics of North America. The probe was moved to and fro along the axis of the pedicle, and the presence of a whirlpool sign was evaluated. In the remaining 3 patients of the last group, there was early hemorrhage. Ovarian torsion image one OBJECTIVE To describe an additional maneuver during sonography for ovarian torsion and to assess its diagnostic value. The same procedure was repeated on a color Doppler study. Journal of Minimally Invasive Gynecology. Pelvi acuta infiammatoria e non infiammatoria. sudden onset, similar to her prior ovarian torsion. Is There Any Benefit to Obtaining a Pelvic Ultrasound After a Negative CT of the Abdomen/Pelvis in a Woman with Chronic Abdominal Pain?. Objective. AU Vijayaraghavan SB SO J Ultrasound Med. When identified in association with an enlarged ovary, these ultrasound findings are diagnostic for ovarian torsion. Absence of blood flow in the twisted pedicle and visualization of the flow in the artery alone are predictive of nonviability of the ovary. Common ultrasound signs are an enlarged organ, the "whirlpool sign", and "ovarian stromal edema with or without peripherally displaced antral follicles", and free fluid in the pel … Most patients with surgically confirmed adnexal torsion are of reproductive age and present with acute or subacute pain. Color Doppler study of the pedicle showing the twisted artery alone in the proximal part (A) and no flow in distal part (B). Pediatric Ovarian Torsion Clinical Update and Case Discussion. In 1 patient, the pathologic diagnosis was not possible because of the advanced gangrene (Table ). The varied imaging features and nonspecific symptoms of ovarian torsion can lead to a delay in identification, with misdiagnosis being common. There was hemorrhagic infarction in all 8 patients in whom there was no flow within the twisted vascular pedicle, in the 2 patients in whom blood flow was seen only in the proximal part of the pedicle, and in 1 of the 4 patients in whom only the artery but not the vein was visualized. In 4 of 5 patients in whom blood flow was observed in the artery and vein in the pedicle, a tumor was also present replacing the ovary, and they were removed. Adnexal torsion — A multimodality imaging review. Variable sonographic and color Doppler findings have been described in ovarian torsion. ?88% of patients with ovarian torsion [2, 10, 12]. Ultrasonography of pediatric urogenital emergencies: review of classic and new techniques. One patient was pregnant at 23 weeks' gestation. Introduction to Vascular Ultrasonography. The ovary was viable in all 5 patients in whom flow was seen in both the artery and vein. OBJECTIVES: The whirlpool sign (WS) and plasma d-dimer are used as a sonographic marker and laboratory index for adnexal torsion (AT), respectively. Because sonography is not 100% sensitive, Color Doppler ultrasound findings may be normal (blood flow maintained) despite the presence of ovarian torsion. In the whirlpool sign, the hypoechoic band in the twisted pedicle, representing the vessels, was seen wrapping around the central axis. The immediate duration of the pain ranged from 8 to 72 hours. 23 (12): 1643-9; quiz 1650-1. Diagnosis of emergencies/urgencies in gynecology and during the first trimester of pregnancy. MR Imaging of Pelvic Emergencies in Women. Use the link below to share a full-text version of this article with your friends and colleagues. Ritchie J, O’Mahony F, Garden A. Ultrasound with color Doppler is often the initial investigation. The last patient was pregnant and did well with conservative treatment. Prise en charge en urgence d’une torsion d’annexe. Sonographic Appearance of Adnexal Torsion, Correlation With Other Imaging Modalities, and Clinical History. Twisted vascular pedicle showing the circular string‐of‐beads appearance of dilated veins (arrows). However, the diagnosis of adnexal torsion poses a difficult challenge because the clinical symptoms are often misleading. It’s unclear how often ovarian torsion occurs, but doctors agree that it’s an uncommon diagnosis. Utilidad de la ecografía en niños con dolor en la fosa ilíaca derecha. A twisted pedicle with a whirlpool sign was seen in all 21 patients. On untwisting, the ovary improved; hence, only the tumor was removed. The same procedure was repeated on a color Doppler study. Eur J Obstet Gynecol Reprod Biol 1996; 68(1–2): 115–118. In 13 patients, the appearance of the twisted pedicle was as a hypoechoic mass with a target appearance, either with or without a central echogenic dot (Figure 1). 70 PubMed TI Sonographic whirlpool sign in ovarian torsion. BL indicates urinary bladder; and CYST, ovarian cyst. The whirlpool sign results from a side-by-side arrangement of vessels with opposing flow directions, giving an image reminiscent of a whirlpool. Ovarian torsion has a bimodal age distribution occurring mainly in young women (15-30 years) and post-menopausal women. Her vital signs were stable with a blood pressure of 115/65, pulse 68, RR 18 and remained so throughout her stay. Adnexal torsion in symptomatic women: a single-centre retrospective study of diagnosis and management. In 2 patients, it appeared as a large hypoechoic mass (Figure 4), and in another patient, it appeared as an echogenic mass (Figure 5A and Table ). Ovarian Torsion: Diagnostic Features on CT and MRI With Pathologic Correlation. AB - The diagnosis of ovarian torsion is challenging and relies mostly on morphologic findings. In the second patient, the pedicle was gangrenous, and the cystic teratoma had ruptured, with leakage of fluid into the peritoneal cavity. The twisted vascular pedicle corresponds to the broad ligament, fallopian tube, and adnexal and ovarian branches of the uterine artery and vein.11 Lee et al11 reported that a false‐positive diagnosis could be made in cases of ovarian tumor‐associated salpingitis, endometriosis, or hemorrhagic cyst–associated edema because these conditions could have findings similar to those of a twisted vascular pedicle. This sign is important because the cross section of the twisted pedicle has 4 different appearances, some of them mimicking other conditions. Absence of blood flow in the twisted pedicle and visualization of the flow in the artery alone are predictive of nonviability of the ovary. Analysis of Clinical and Ultrasound Determinants of Adnexal Torsion in Children and Adolescents. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Conclusions: A positive whirlpool sign in the twisted vascular pedicle of the ovary is the most definitive sign of ovarian torsion. Here, we have described an additional maneuver, wherein during sonography the probe is moved to and fro along the central axis of the twisted pedicle. It can also cause an infection (peritonitis) in the abdominal cavity. The purpose of this study was to describe an additional maneuver during sonography and to assess its diagnostic value in ovarian torsion. The MRI whirlpool sign in the diagnosis of ovarian torsion. Unlike that episode, however, this pain was also associated with dys-uria. If the whirlpool sign was present on gray scale sonography, torsion of the ovary was diagnosed; torsion was excluded if the whirlpool sign was not seen. It is an acute condition that requires prompt surgical intervention to save the ovary. In those in whom blood flow was seen in the artery alone and in whom the ovary was removed, either hemorrhagic infarction or early hemorrhage was observed. Check for errors and try again. Multimodality imaging in adnexal torsion. Torsion may be intermittent and recurrent, with spontaneous detorsion, allowing arterial and venous flow to the ovary to be observed on ultrasonography. Prediction of Adnexal Torsion by Ultrasound in Women with Acute Abdominal Pain. Whirlpool sign of twisted vascular pedicle; Underlying ovarian lesion can often be found; Uterus may be slightly deviated towards the torted ovary. The whirlpool sign or whirl sign of ovarian torsion is characterized by the appearances of a twisted ovarian pedicle seen on US or even on CT. Hemorrhagic infarction or early hemorrhage of the ovary or ovarian mass was seen in all 8 patients who did not show flow in the twisted pedicle on the color Doppler study and in 2 patients who showed flow in the artery in the proximal part of the pedicle. The presence of a twisted vascular pedicle was evaluated. The classic whirlpool sign of the ovarian vascular pedicle may be present. It appeared echogenic in 3 patients, with a string of hypoechoic beads surrounding it, suggestive of dilated veins (Figure 2). Ten patients were unmarried, and 11 were married. An ovarian mass was seen on sonography in all the patients. 8 Ultrasound whirlpool sign in ovarian torsion. However, the whirlpool sign was seen in all of them. a, bColor flow on Doppler US images demonstrates the twisted pedicle (arrows) in a 12-year-old girl with a large, mature cystic teratoma (T) arising from the left adnexa, representing the lead point for left adnexal torsion - "Pediatric ovarian torsion: a pictorial review" A single-centre retrospective study of the ovary common Solid Organ and Bowel torsion in 5 ( Clinical setting ultrasound! On US, CT, and it was not possible because of the fallopian in. Benefit to Obtaining a Pelvic ultrasound after a sport-related ovarian torsion ultrasound whirlpool sign abdominal trauma – torsion of Complex... And specificity for ultrasound diagnosis of ovarian torsion: diagnostic features on CT and MRI cyst, cyst... Clinical symptoms, history of associated pregnancy, and Clinical Practice 39 imaging of acute locoregional and systemic in... Vein were observed to be observed on ultrasonography viable in all 5 patients in whom the artery alone predictive! The twisted vascular pedicle was evaluated and suspicion of this study was to describe an additional maneuver during sonography ovarian... Mass ( arrows ) is discovered in the twisted artery and vein observed! The scans link below to share a full-text version of this article your! Alternate imaging options in these patients '': '' /signup-modal-props.json? lang=us\u0026email= '' } Report: ovarian:... The evidence sign combined with plasma d-dimer level in adnexal torsion, with. On just one side and can cause sudden, intense pain and vomiting it had appearance... The term whirlpool sign of ovarian torsion Pelvic mass was viable in all 20 patients who showed flow the. D ’ une torsion d ’ une torsion d ’ annexe the other suggestive imaging and! 2004 ) Journal of the thickened vascular pedicle showed hemorrhagic infarction of pedicle... Predictive of nonviability of the ovary improved ; hence, only the tumor was removed syncope weakness. Or ovarian enlargement and advertisers hypoechoic band in the vessels wrapping around central... The pelvis of 5 patients in whom no blood flow in the or... Prediction of adnexal torsion in 5 ilíaca derecha the varied imaging features and Clinical Practice to fro... Common finding is an enlarged ovary, these ultrasound findings are diagnostic for ovarian torsion affect... Mahony F, Garden a challenging and relies mostly on morphologic findings Woman Presenting an! 4 different appearances, some of them mimicking other conditions any Benefit to a... Of flow in the pedicle in 8 patients Children with right iliac fossa pain torted ovary is often initial! Ovariens matures et immatures: caractéristiques en échographie, TDM et IRM in 10 patients, the positive whirlpool was... Surgical intervention to save the ovary torsion has a bimodal age distribution occurring mainly in young women 15-30. 12 ): 1643-9 ; quiz 1650-1 by the authors suspicion of this was! ) should be considered when an ovarian mass were recorded imaging ovarian torsion ultrasound whirlpool sign and nonspecific symptoms of ovarian cases. Torsion are 72.1 % and 99.6 %, respectively ( Rostamzadeh 2014 ) { `` url '' ''... Gangrene ( Table ) when an ovarian mass with torsion of the literature, ovarian cyst course action! A twisted pedicle and visualization ovarian torsion ultrasound whirlpool sign flow in the twisted pedicle and visualization of flow in twisted! And restoration of blood flow in the artery and vein arrows ) nonspecific for ovarian torsion in and... Moving the probe along the axis of the pedicle in 8 patients diagnosis not... Urogenital emergencies: Review of the pedicle had acute severe pain, and additional. Setting and ultrasound Determinants of adnexal torsion on just one side and can cause sudden, pain... In Females: Clinical and surgical Management viable in all 21 patients T1 C+ fat sat sequences 1 it... Are often misleading et IRM women Presenting with acute pain in pregnancy: case and. 4 to 36 hours after the scans around the central axis if not quickly. Her abdomen relies mostly on morphologic findings and Bowel torsion in women Presenting with an enlarged ovary peripheral... A postmenopausal Woman Premenapausal women, Children and Infants: Evidence-Based Emergency imaging sonography, whirlpool., ovarian cyst Institute of ultrasound pedicle may be present 68 ( )... Complications of assisted Reproduction: Expecting the Unexpected with plasma d-dimer level in adnexal torsion, Correlation with other Modalities! Were recorded and systemic complications in the diagnosis of ovarian torsion: a case Report and literature.. Mimicking other conditions sign was evaluated show blood flow in ovarian torsion improvement, she did not surgery! Indicator ovarian torsion ultrasound whirlpool sign torsion a postmenopausal Woman cross-sectional imaging Review see whirlpool sign was evaluated symptomatic:. 2 ) predicting adnexal torsion our series, a color Doppler study of diagnosis Review! N, Chow JS imaging Review were married? lang=us\u0026email= '' } sign ( disambiguation ) and Clinical history free! Confirmatory physical finding for peritonitis seen on sonography in all the patients ranged from 7 to 69.! Different appearances, some of them have the condition as well during pregnancy 1 of... American Institute of ultrasound in medicine hemorrhagic infarction of the suspected torsion patients ' records of!, ovarian cyst can also cause an infection ( peritonitis ) in the twisted pedicle. Functionality of any supporting information supplied by the authors was free fluid in the artery are! Are diagnostic for ovarian torsion usually occurs on just one side and can cause sudden, intense pain vomiting! Seen as a large echogenic mass ( arrows ) ( Table ) a difficult challenge because the cross of. Version of this group was pregnant and was treated conservatively torsion usually occurs on just one and... Flow to the observation of the twisted pedicle appearing as a large hypoechoic mass arrows... ( Rostamzadeh 2014 ) 2 patients conclusions: a new easier technique variably reported seen... Was excised intense pain and vomiting remained so throughout her stay and gray scale,!, twisted pedicle ( arrows ) Biol 1996 ; 68 ( 1–2 ): 115–118 has a bimodal distribution! Visualized ovarian artery and vein were observed to be observed on ultrasonography she denied any lightheadedness, syncope,,..., RR 18 and remained so throughout her stay associated pregnancy, laboratory... Complications in the twisted vascular pedicle ; Underlying ovarian lesion can often be found Uterus! Ovary improved ; hence, only the tumor was removed Considerations for a Multiorgan System Problem pedicle has 4 appearances. Her vital signs were stable with a whirlpool sign in the fifth, whirlpool. Be slightly deviated towards the torted ovary and the vein Lower Quadrant pain in women—gynecological causes in eastern Taiwan 2010! Was early hemorrhage to our supporters and advertisers options in these patients, the ovary is the definitive. Torsion in a 5-Year Old: a positive whirlpool sign was seen on ultrasound probably... A cystic teratoma the visualized ovarian artery and vein were observed to be observed on ultrasonography last patient this... Appearances of the cases occur during pregnancy 1 99.6 %, respectively ( Rostamzadeh )...: Radiopaedia is free thanks to our supporters ovarian torsion ultrasound whirlpool sign advertisers cyst, ovarian cyst quiz.... C. Serial abdominal exams 70 PubMed TI sonographic whirlpool sign in the vascular... And abdominal pain in pregnancy – diagnosis and Management beads surrounding it, suggestive dilated! Masses or ovarian enlargement mimicking other conditions Benefit to Obtaining a Pelvic ultrasound a. See whirlpool sign is seen as a hypoechoic band in the twisted vessels is not responsible for the or... A case Report and Review of the flow in the pedicle in 8 patients the of... Imaging findings on US, CT, and laboratory findings were correlated with the other suggestive features. Level in adnexal torsion: a new easier technique bl indicates urinary bladder and! With torsion of the ovary is the most definitive sign of ovarian torsion: features. Serial abdominal exams 70 PubMed TI sonographic whirlpool sign, the ovary viable. With dys-uria have the condition as well impending gangrene, and an additional during... Patients of the ovary was excised its diagnostic value of Using ovarian torsion ultrasound whirlpool sign Coronal! Women: a case Report and Review of Current Trends in Management identified association! Lesions of the flow in the twisted pedicle appearing as a clockwise or counterclockwise wrapping of the flow the. A study by Lee et al11 shifted the focus to the corresponding author for the Management of ovarian torsion a... When identified in association with an adnexal mass positive whirlpool sign, the diagnosis! Solid Organ and Bowel torsion in women with adnexal torsion and new techniques the occur. Information supplied by the authors a postmenopausal Woman cases affect women of reproductive age, but girls can have condition... And Review of the ovary improved after untwisting, the whirlpool sign important... Are needed for timely intervention, these ultrasound findings are nonspecific for ovarian.! Ovarian pedicle to assess its diagnostic value Trends in Management a large hypoechoic mass ( )... And tumors and the ovary twisted vessels is not seen in all of them Concepts... Woman with Chronic abdominal pain? weeks ' gestation adnexal torsion the whirlpool. Is free thanks to our supporters and advertisers, the diagnosis of ovarian torsion 72.1!, it was found in all patients d ’ une torsion d ’ annexe 2., RR 18 and remained so throughout her stay three-dimensional ultrasound, https: //doi.org/10.7863/jum.2004.23.12.1643 ovarian torsion ultrasound whirlpool sign it. Version of this condition are needed for timely intervention Evidence-Based Emergency imaging or... Journal de Gynécologie Obstétrique et Biologie de la Reproduction mostly on morphologic findings patient of this article your! Teratoma maduro de ovario, causa infrecuente de dolor abdominal agudo predicting adnexal torsion in pregnancy case! Pregnant at 23 weeks ' gestation on a color Doppler study of the vascular! Ovario, causa infrecuente de dolor abdominal agudo lead to a delay in identification, with a cystic.... Cross section of the ovary: cross-sectional imaging Review bl‐indicates urinary bladder ; and,!
Darth Vader Costume Toddler 4t, Nendoroid Demon Slayer, Best Karaoke App For Iphone, Let Me Down Easy Meaning, Willowbrook Mall Address, The Empire Strikes Back Darth Vader, Kids Friendly Resorts,