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Ovarian torsion accounts for about 3% of gynecologic emergencies. The incidence of ovarian torsion among women of all ages is 5.9 per 100,000 women, and the incidence among women of reproductive age (15–45 years) is 9.9 per 100,000 women. [15] In 70% of cases, it is diagnosed in women between 20 and 39 years of age.
The Whirlpool sign also known as the Whirl sign [1] is related to mesentery when the bowel rotates around the mesentery causing a swirling appearance of the mesentery around the mesenteric vessels. [2] It can also be related to ovaries when twisting of the vascular pedicle of the ovaries takes place. [3] [4]
Ovarian cysts such as theca lutein cysts can cause ovarian torsion. Torsion occurs when the cysts enlarge the ovaries, causing an imbalance resulting in the twisting of the fallopian tubes. [25] As a result, blood flow to the ovaries is restricted which can cause infarction of the tissue. This requires prompt surgical treatment. [25]
One of the most important factors used to determine the clinical suspicion of malignancy of an adnexal mass is the sonographic appearance of the mass. [2] Indications that the mass is at a higher risk of being malignant include the presence of loculations, nodules , papillary structures, septations , or a size greater than 10 cm. [ 3 ] [ 4 ]
Ovarian torsion may be more likely during pregnancy, especially during the third and fourth months of pregnancy, as the internal anatomy shifts to accommodate fetal growth. [5] Diagnosis relies on clinical examination and ultrasound imaging. [5] Cysts larger than 4 cm are associated with approximately 17% risk. [citation needed]
Large cysts can lead to torsion of the adnexa inflicting acute pain. [3] [4] Prior to surgery, PTCs are usually seen on ultrasonography. However, because of the proximity of the ovary that may display follicle cysts, it may be a challenge to identify a cyst as paratubal or paraovarian. [5]
The most accurate ultrasound test can detect 96% of ovarian cancers in postmenopausal women, new research suggests. The findings indicate that the test should replace the current standard of care ...
The ovarian fibroma, also fibroma, is a benign sex cord-stromal tumour. Ovarian fibromas represent 4% of all ovarian neoplasms. [ 1 ] They tend to occur mostly during perimenopause and postmenopause , the median age having been reported to be about 52 years, and they are rare in children . [ 1 ]