{ "schemaVersion": 2, "eyebrow": "Gynecology emergency", "title": "Ovarian Torsion", "summary": "Ovarian torsion is a time-sensitive surgical diagnosis. Neither normal Doppler flow nor nondiagnostic ultrasonography excludes torsion; when clinical concern persists, expedite gynecologic evaluation and diagnostic laparoscopy, with detorsion and ovarian preservation favored whenever technically feasible.", "seoDescription": "Ovarian torsion diagnosis and management: ultrasound interpretation, limitations of Doppler flow, emergency laparoscopy, detorsion, and ovarian preservation.", "clinicalQuestion": "How should clinicians evaluate suspected ovarian torsion and act when imaging is equivocal?", "specialty": "Obstetrics and Gynecology", "audience": "U.S. physicians and medical trainees", "tags": [ "ovarian torsion", "adnexal torsion", "Doppler ultrasound", "whirlpool sign", "diagnostic laparoscopy", "detorsion" ], "keyTakeaways": [ "Treat suspected ovarian torsion as a surgical emergency: no clinical, laboratory, or imaging criterion reliably confirms or excludes the diagnosis before laparoscopy.[15]", "Normal arterial Doppler flow does not exclude torsion because intermittent or partial torsion and dual ovarian blood supply may preserve flow.[15]", "Use ultrasonography to identify supportive findings and alternatives, but obtain urgent gynecologic consultation when pretest concern remains high despite equivocal imaging.[10][11][15]", "At laparoscopy, detorse and preserve the adnexa regardless of a blue-black appearance; oophorectomy should be exceptional and technically unavoidable.[15]" ], "sections": [ { "id": "when-to-suspect", "eyebrow": "Recognition", "heading": "When suspicion should override a nondiagnostic workup", "intro": "The decision problem is whether to proceed to urgent operative assessment, not to achieve imaging certainty.", "paragraphs": [ "Torsion may be complete, partial, or intermittent. Progressive venous and lymphatic obstruction precedes arterial compromise, producing edema and ovarian enlargement; preserved arterial flow therefore remains compatible with clinically important torsion.[11][15]", "Acute unilateral pelvic or lower abdominal pain with nausea or vomiting is the classic pattern, but pain may fluctuate, evolve over hours to days, or be less severe than expected. Torsion occurs across the age spectrum, including premenarchal patients, pregnancy, and postmenopause.[10][11][15]", "An adnexal mass or cyst is a major risk factor, especially when larger than 5 cm; however, pediatric and adolescent torsion may involve a normal-appearing ovary without an associated mass in as many as 46% of cases.[11][15]" ], "bullets": [ "Escalate concern with unilateral pain plus an adnexal mass, ovarian enlargement, vomiting, prior torsion, pregnancy, ovarian stimulation, or polycystic ovaries.[10][11][15]", "Do not use leukocytosis, pyuria, CRP, or ESR to rule in or rule out torsion; ACOG identifies these as unhelpful diagnostic tests in adolescents.[15]" ], "subsections": [], "table": { "caption": "", "columns": [], "rows": [] } }, { "id": "diagnostic-approach", "eyebrow": "Diagnosis", "heading": "Imaging supports risk assessment but does not rule out torsion", "intro": "Use imaging to identify supportive anatomy, assess mimics, and guide consultation—not to defer indicated surgery.", "paragraphs": [ "Pelvic ultrasonography is the preferred initial imaging test in adolescents, generally transabdominal; assessment should include ovarian size and morphology, follicles, free fluid, vascular pedicle, and Doppler interrogation when feasible.[15] A systematic review cited in the supplied literature reports substantial variability in ultrasound sensitivity, reflecting operator and technical dependence.[3][10]", "Supportive sonographic findings include unilateral ovarian enlargement, stromal edema with peripheral follicles, free fluid, and a twisted vascular pedicle or whirlpool sign.[15] The whirlpool sign is highly specific when visualized but technically difficult to detect, particularly with transabdominal scanning.[15]", "Color and spectral Doppler are adjuncts, not exclusion tests. In surgically confirmed torsion, normal Doppler arterial flow has been reported in up to 60% of cases; preserved flow may reflect intermittent torsion, partial torsion, collateral supply, or a torsed paratubal cyst.[15]" ], "bullets": [ "Order pregnancy testing in reproductive-capable patients and evaluate competing urgent diagnoses, including ectopic pregnancy, ruptured or hemorrhagic cyst, appendicitis, and urinary tract pathology; absence of an alternative diagnosis increases the weight of a concerning clinical presentation.[10][11][13]", "If CT is obtained for undifferentiated abdominal pain, assess for asymmetric ovarian enlargement, ipsilateral uterine deviation, pelvic free fluid, and periovarian fat stranding. CT findings concerning for torsion should prompt surgery rather than delay for confirmatory ultrasonography.[15]", "MRI may further characterize equivocal adnexal findings when clinically appropriate, but it should not delay operative management when torsion is suspected.[15]" ], "subsections": [], "table": { "caption": "Imaging interpretation in suspected torsion", "columns": [ "Finding", "Interpretation", "Action" ], "rows": [ [ "Enlarged edematous ovary, peripheral follicles, free fluid, or whirlpool sign", "Supports torsion; the whirlpool sign is particularly specific when seen.[15]", "Urgent gynecologic consultation and operative planning in the appropriate clinical context.[15]" ], [ "Absent or reduced Doppler flow", "Raises concern for advanced vascular compromise but is not required for torsion.[10][15]", "Treat as high-risk; do not delay surgical assessment for additional confirmatory testing.[15]" ], [ "Normal arterial Doppler flow", "Does not exclude partial, intermittent, or early torsion.[15]", "Proceed according to overall clinical suspicion; consultation remains indicated when concern persists.[15]" ], [ "CT features concerning for torsion", "May identify torsion in patients imaged for nonspecific abdominal pain.[15]", "Do not delay surgery to obtain ultrasonography solely for confirmation.[15]" ] ] } }, { "id": "operative-management", "eyebrow": "Management", "heading": "Urgent laparoscopy is both diagnostic and therapeutic", "intro": "There is no preoperative test that reliably excludes torsion in a patient with concerning symptoms and supportive findings.", "paragraphs": [ "Adnexal torsion is a surgical diagnosis. When suspicion is clinically meaningful, timely diagnostic laparoscopy is indicated to preserve ovarian function and fertility, even though torsion may not be identified in a substantial fraction of explorations and alternative gynecologic pathology may be found and treated.[15]", "Laparoscopy is the preferred operative approach in adolescents. The operative goal is detorsion and preservation of adnexal structures rather than resection based on color or perceived ischemia.[15] The gross blue-black appearance of an ovary is not a reliable marker of irreversible nonviability; ovarian function has been reported after detorsion despite ischemic appearance.[15]", "Perform oophorectomy only when unavoidable, such as when the ovary is structurally non-salvageable and falls apart during surgery. The concern that detorsion causes embolic complications is unsupported in the ACOG guidance cited here.[15]" ], "bullets": [ "Avoid delaying operative evaluation to establish a symptom-duration threshold. The duration of vascular interruption that predicts irreversible loss is unknown.[10][15]", "If a cyst is present, cystectomy may be performed when feasible, but it is not mandatory at detorsion; severe edema and friability may make cystectomy more destructive than deferral.[15]", "For a large cyst not removed at detorsion, drainage may be considered and interval ultrasonography at 6-12 weeks is recommended in adolescents.[15]" ], "subsections": [ { "heading": "Oophoropexy", "paragraphs": [ "Oophoropexy is generally reserved for repeat torsion or an absent contralateral ovary. Recurrence is reported as low overall, and available evidence is insufficient to support routine oophoropexy after a first torsion episode.[15]" ], "bullets": [] } ], "table": { "caption": "", "columns": [], "rows": [] } }, { "id": "special-populations", "eyebrow": "Population-specific decisions", "heading": "Pediatric and adolescent management prioritizes future ovarian function", "intro": "Young patients have distinctive epidemiology and a particularly high value of ovarian preservation.", "paragraphs": [ "In adolescents, benign functional cysts and benign teratomas are common pathologies associated with torsion, whereas malignancy presenting as torsion is rare.[15] The possibility of malignancy should not be used as a default rationale for oophorectomy in this population.[15]", "Diagnostic laparoscopy is appropriate when torsion is suspected despite uncertain imaging. A negative laparoscopy is considered an acceptable consequence of a fertility-preserving strategy, particularly because alternative gynecologic pathology is often identified.[15]" ], "bullets": [ "A bimanual examination is often unnecessary or poorly tolerated in pediatric and adolescent patients; tailor examination to the patient and clinical need.[15]", "Use pediatric-specific laparoscopic precautions, including attention to port placement and insufflation pressure, because anatomy and abdominal wall properties differ from adults.[15]" ], "subsections": [], "table": { "caption": "", "columns": [], "rows": [] } }, { "id": "emerging-tools", "eyebrow": "Evidence gap", "heading": "Emerging imaging and artificial intelligence are not ready to direct care", "intro": "Novel methods are investigational and must not delay established surgical pathways.", "paragraphs": [ "Photoacoustic-ultrasound imaging quantified tissue oxygen saturation in rat torsion models and detected progressive hypoxia during prolonged partial torsion; this is preclinical evidence, not a validated diagnostic or viability test in humans.[3]", "A retrospective Korean CT deep-learning study reported patient-level AUC of 0.80 for adnexal cystic torsion using a 3D EfficientNet model. The authors identified heterogeneous CT protocols, limited regional annotations, and lack of external validation as major limitations; the model should be considered investigational rather than a replacement for radiologist interpretation or clinical judgment.[4]" ], "bullets": [ "Do not use experimental tissue oxygenation measures, CT algorithms, or imaging-derived estimates of torsion duration to decide between detorsion and oophorectomy.[3][4][15]" ], "subsections": [], "table": { "caption": "", "columns": [], "rows": [] } } ], "faq": [ { "question": "Can normal Doppler flow exclude ovarian torsion?", "answer": "No. Normal arterial flow may persist with partial or intermittent torsion or because of collateral ovarian supply. Doppler flow alone should not determine management when clinical suspicion persists.[15]" }, { "question": "What ultrasound findings are most useful for ovarian torsion?", "answer": "Unilateral enlargement, stromal edema with peripheral follicles, free fluid, and a twisted pedicle or whirlpool sign support the diagnosis. A normal-appearing ovary decreases likelihood but does not replace clinical judgment.[15]" }, { "question": "Should a dark or blue-black torsed ovary be removed?", "answer": "Not based on appearance alone. ACOG recommends laparoscopic detorsion and adnexal preservation regardless of gross appearance, reserving oophorectomy for an ovary that is technically unsalvageable.[15]" }, { "question": "Should CT-positive torsion be followed by ultrasound before surgery?", "answer": "No. If CT obtained for abdominal pain shows findings concerning for torsion, surgery should not be delayed solely to obtain ultrasonographic confirmation.[15]" } ], "references": [ { "number": 1, "title": "BMJ Open is committed to open peer review. As part of this ...", "detail": "bmjopen.bmj.com", "url": "https://bmjopen.bmj.com/content/bmjopen/15/3/e088869.draft-revisions.pdf", "authors": "bmjopen.bmj.com", "host": "bmjopen.bmj.com" }, { "number": 2, "title": "European Glaucoma Society Terminology and Guidelines ...", "detail": "bjo.bmj.com", "url": "https://bjo.bmj.com/content/bjophthalmol/105/Suppl_1/1.full.pdf", "authors": "bjo.bmj.com", "host": "bjo.bmj.com" }, { "number": 3, "title": "Dual-modal photoacoustic and ultrasound imaging for early diagnosis of ovarian torsion and evaluation of long-term tissue hypoxia | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-025-17381-8", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 4, "title": "Adnexal torsion diagnosis framework with CT-based adaptive preprocessing and deep neural networks", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-026-50736-3", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 5, "title": "Ovarian and Adnexal Torsion: Diagnosis and Management | Nature Research Intelligence", "detail": "www.nature.com", "url": "https://www.nature.com/research-intelligence/nri-topic-summaries/ovarian-and-adnexal-torsion-diagnosis-and-management-micro-68149", "authors": "www.nature.com", "host": "www.nature.com" }, { "number": 6, "title": "The Management of Ovarian Hyperstimulation Syndrome ...", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.70195", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com" }, { "number": 7, "title": "Re‐torsion of the ovaries - Hyttel - Obstetrics and Gynecology", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.12542", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com" }, { "number": 8, "title": "Ovarian torsion: a modern approach to management - Bailey", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/tog.12985", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com" }, { "number": 9, "title": "Ovarian torsion: a modern approach to management", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/tog.12985", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com" }, { "number": 10, "title": "The Elusive Diagnosis of Ovarian Torsion : Emergency Medicine News", "detail": "journals.lww.com", "url": "https://journals.lww.com/em-news/fulltext/2025/01000/the_elusive_diagnosis_of_ovarian_torsion.8.aspx", "authors": "journals.lww.com", "host": "journals.lww.com" }, { "number": 11, "title": "High risk and low prevalence diseases: Ovarian torsion", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0735675722002042", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 12, "title": "Diagnosis of Ovarian Torsion: Is It Time to Forget About Doppler? - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1701216317307922", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 13, "title": "The Sonographic Diagnosis of Ovarian Torsion: Pearls and Pitfalls - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1556858X0700014X", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 14, "title": "Key clinical predictors in the diagnosis of ovarian torsion in children - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0021755724000317", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com" }, { "number": 15, "title": "Adnexal Torsion in Adolescents : Obstetrics & Gynecology", "detail": "journals.lww.com", "url": "https://journals.lww.com/greenjournal/fulltext/10.1097/aog.0000000000003373~adnexal-torsion-in-adolescents-acog-committee-opinion-no-783", "authors": "journals.lww.com", "host": "journals.lww.com" }, { "number": 16, "title": "American Society for Clinical Pharmacology and Therapeutics", "detail": "ascpt.onlinelibrary.wiley.com", "url": "https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.993", "authors": "ascpt.onlinelibrary.wiley.com", "host": "ascpt.onlinelibrary.wiley.com" }, { "number": 17, "title": "SAEM25 Abstracts - 2025 - Academic Emergency Medicine", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/acem.70052?af=", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com" }, { "number": 18, "title": "Common Gynecologic Issues in Patients Post‐Kidney ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/ctr.70560", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com" }, { "number": 19, "title": "Abstracts at CIDSCON 2024 : Journal of Clinical Infectious ...", "detail": "journals.lww.com", "url": "https://journals.lww.com/cids/fulltext/2024/02030/abstracts_at_cidscon_2024.13.aspx", "authors": "journals.lww.com", "host": "journals.lww.com" }, { "number": 20, "title": "Dual‐Drug‐Loaded Liposomes: Design Strategies ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/full/10.1002/mba2.70060", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com" }, { "number": 21, "title": "Poster Abstracts", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/pdf/10.1111/fcp.12190", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com" }, { "number": 22, "title": "Emergency, Point-of-Care, and Clinical Ultrasound ...", "detail": "www.annemergmed.com", "url": "https://www.annemergmed.com/article/S0196-0644(23)00432-8/abstract", "authors": "www.annemergmed.com", "host": "www.annemergmed.com" }, { "number": 23, "title": "Postoperative complications following gender-affirming vaginoplasty: an acs nsqip study", "detail": "www.ajog.org", "url": "https://www.ajog.org/article/S0002-9378(21)02831-3/pdf", "authors": "www.ajog.org", "host": "www.ajog.org" }, { "number": 24, "title": "Changing practices in the surgical management of adnexal torsion: an analysis of the national surgical quality improvement project (NSQIP) database", "detail": "www.ajog.org", "url": "https://www.ajog.org/article/S0002-9378(21)02830-1/pdf", "authors": "www.ajog.org", "host": "www.ajog.org" } ], "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "BMJ Open is committed to open peer review. As part of this ...", "detail": "bmjopen.bmj.com", "url": "https://bmjopen.bmj.com/content/bmjopen/15/3/e088869.draft-revisions.pdf", "authors": "bmjopen.bmj.com", "host": "bmjopen.bmj.com", "snippet": "n (%) Any event 3 (<1) 10 (<1) Transient ischaemic attack 0 3 (<1) Vertebrobasilar insufficiency 2 (<1) 0 Carotid artery disease 0 1 (<1) Carpal tunnel syndrome 0 1 (<1) Cervical radiculopathy 0 1 (<1) Epilepsy 0 1 (<1) Headache 0 1 (<1) Ischaemic stroke 0 1 (<1) Lumbosacral radiculopathy 0 1 (<1) M", "score": 0.07311853 }, { "number": 2, "title": "European Glaucoma Society Terminology and Guidelines ...", "detail": "bjo.bmj.com", "url": "https://bjo.bmj.com/content/bjophthalmol/105/Suppl_1/1.full.pdf", "authors": "bjo.bmj.com", "host": "bjo.bmj.com", "snippet": "Clinical considerations – – Disease-associated maternal and/ or embryo/feral risk – – Dose adjustment during pregnancy and postpartum – – Miaternal adverse reactions – – Fetal/neonatal adverse reactions – – Labor or delivery Data – – Human – – Animal Lactation Risk summary Summarize information of t", "score": 0.052293845 }, { "number": 3, "title": "Dual-modal photoacoustic and ultrasound imaging for early diagnosis of ovarian torsion and evaluation of long-term tissue hypoxia | Scientific Reports", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-025-17381-8", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Article \n PubMed \n Google Scholar\n6. Sandrieser, L., Perricos, A., Husslein, H., Wenzl, R. & Kuessel, L. Fertility preserving management of ovarian torsion. Fertil. Steril. 120, 1257–1258. (2023).\n\n Article \n PubMed \n Google Scholar\n7. Dawood, M. T. et al. Adnexal torsion: review of radio", "score": 0.29675663 }, { "number": 4, "title": "Adnexal torsion diagnosis framework with CT-based adaptive preprocessing and deep neural networks", "detail": "www.nature.com", "url": "https://www.nature.com/articles/s41598-026-50736-3", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "The primary objective of the chart review was to classify patients into the adnexal cystic torsion (disease) group or the control group for the development of the deep learning algorithm. The disease group was further subdivided according to the initial clinical presentation department. A subgroup i", "score": 0.29319245 }, { "number": 5, "title": "Ovarian and Adnexal Torsion: Diagnosis and Management | Nature Research Intelligence", "detail": "www.nature.com", "url": "https://www.nature.com/research-intelligence/nri-topic-summaries/ovarian-and-adnexal-torsion-diagnosis-and-management-micro-68149", "authors": "www.nature.com", "host": "www.nature.com", "snippet": "Title: Ovarian and Adnexal Torsion: Diagnosis and Management | Nature Research Intelligence\n# Ovarian and Adnexal Torsion: Diagnosis and Management. * Ovarian and Adnexal Torsion: Diagnosis and Management. Ovarian and adnexal torsion represent acute gynecological emergencies marked by the twisting o", "score": 0.54346967 }, { "number": 6, "title": "The Management of Ovarian Hyperstimulation Syndrome ...", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.70195", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "This guideline is for healthcare professionals who care for women, non-binary, and trans people with ovarian hyperstimulation syndrome (OHSS).", "score": 0.4186262 }, { "number": 7, "title": "Re‐torsion of the ovaries - Hyttel - Obstetrics and Gynecology", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.12542", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "by TEW Hyttel · 2015 · Cited by 44 — This review addresses risk of re-torsion and describes preventive strategies to avoid re-torsion in pre-menarcheal girls, and fertile and", "score": 0.36758858 }, { "number": 8, "title": "Ovarian torsion: a modern approach to management - Bailey", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/10.1111/tog.12985", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "by F Bailey · 2025 · Cited by 9 — Predominating clinical features may include sudden onset lower abdominal or pelvic pain that is unilateral, fluctuating and severe. In cases of", "score": 0.32018378 }, { "number": 9, "title": "Ovarian torsion: a modern approach to management", "detail": "obgyn.onlinelibrary.wiley.com", "url": "https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/tog.12985", "authors": "obgyn.onlinelibrary.wiley.com", "host": "obgyn.onlinelibrary.wiley.com", "snippet": "by F Bailey · 2025 · Cited by 8 — In this article, we aim to review current research evidence to present a modern update on diagnosis and management,", "score": 0.2677136 }, { "number": 10, "title": "The Elusive Diagnosis of Ovarian Torsion : Emergency Medicine News", "detail": "journals.lww.com", "url": "https://journals.lww.com/em-news/fulltext/2025/01000/the_elusive_diagnosis_of_ovarian_torsion.8.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "## Risk Factors and Presentation\n\nBy far, the greatest risk factor is the presence of an ovarian cyst or benign neoplasm. It is critical to note that normal ovaries can undergo torsion, but the presence of any mass is the greatest risk factor. (N Engl J Med. 1963;268:343.) More than 85 percent of pa", "score": 0.42734948 }, { "number": 11, "title": "High risk and low prevalence diseases: Ovarian torsion", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0735675722002042", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Ovarian torsion is one of the most common gynecologic surgical emergencies, typically affecting women between the ages of 29 to 34 years . It refers to the complete or partial rotation of an ovary along the supporting ligaments, resulting in partial or complete ovarian blood flow obstruction. While ", "score": 0.39880496 }, { "number": 12, "title": "Diagnosis of Ovarian Torsion: Is It Time to Forget About Doppler? - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1701216317307922", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Title: Diagnosis of Ovarian Torsion: Is It Time to Forget About Doppler? - ScienceDirect\n# Diagnostic Imaging Diagnosis of Ovarian Torsion: Is It Time to Forget About Doppler? Accuracy of ultrasound in diagnosis of ovarian torsion remains controversial, with some studies reporting correct diagnosis ", "score": 0.36758858 }, { "number": 13, "title": "The Sonographic Diagnosis of Ovarian Torsion: Pearls and Pitfalls - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1556858X0700014X", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Title: The Sonographic Diagnosis of Ovarian Torsion: Pearls and Pitfalls - ScienceDirect\n# The Sonographic Diagnosis of Ovarian Torsion: Pearls and Pitfalls. The use of pelvic sonography has enhanced our ability to accurately evaluate patients at risk for ovarian torsion. To understand the variable ", "score": 0.35911742 }, { "number": 14, "title": "Key clinical predictors in the diagnosis of ovarian torsion in children - ScienceDirect", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0021755724000317", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Title: Key clinical predictors in the diagnosis of ovarian torsion in children - ScienceDirect\n## Jornal de Pediatria. Volume 100, Issue 4, July–August 2024, Pages 399-405. # Original article Key clinical predictors in the diagnosis of ovarian torsion in children. Author links open overlay panel, , ", "score": 0.34760407 }, { "number": 15, "title": "Adnexal Torsion in Adolescents : Obstetrics & Gynecology", "detail": "journals.lww.com", "url": "https://journals.lww.com/greenjournal/fulltext/10.1097/aog.0000000000003373~adnexal-torsion-in-adolescents-acog-committee-opinion-no-783", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Rousseau V, Massicot R, Darwish AA, Sauvat F, Emond S, Thibaud E, et al. Emergency management and conservative surgery of ovarian torsion in children: a report of 40 cases. J Pediatr Adolesc Gynecol 2008;21:201–6.Cited HereCrossRefPubMedGoogle Scholar \n ## 30.\n\nHubner N, Langer JC, Kives S, Allen ", "score": 0.33639696 }, { "number": 16, "title": "American Society for Clinical Pharmacology and Therapeutics", "detail": "ascpt.onlinelibrary.wiley.com", "url": "https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.993", "authors": "ascpt.onlinelibrary.wiley.com", "host": "ascpt.onlinelibrary.wiley.com", "snippet": "UTILITY OF PBPK TO PREDICT EXPOSURE IN RENAL AND HEPATIC IMPAIRMENT POPULATION. ... prescribing changes per FDA or CPIC guidelines for", "score": 0.23506488 }, { "number": 17, "title": "SAEM25 Abstracts - 2025 - Academic Emergency Medicine", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/acem.70052?af=", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Testicular and ovarian torsion are painful surgical emergencies that threaten gonadal function; chronic renal failure. renal impairment or", "score": 0.2125101 }, { "number": 18, "title": "Common Gynecologic Issues in Patients Post‐Kidney ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/ctr.70560", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Contraindications include hepatic impairment and severe renal impairment/ESRD.[77, 79] Given variable renal function in KTR and potential", "score": 0.10044563 }, { "number": 19, "title": "Abstracts at CIDSCON 2024 : Journal of Clinical Infectious ...", "detail": "journals.lww.com", "url": "https://journals.lww.com/cids/fulltext/2024/02030/abstracts_at_cidscon_2024.13.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Results: In 2022, clinical pharmacists at our tertiary care center reviewed 4181 prescriptions, which included 902 interventions related to antibiotics. Renal dose modification (21%) was the frequent intervention, followed by dose adjustment according to weight (10.8%). Furthermore, continuous monit", "score": 0.075210504 }, { "number": 20, "title": "Dual‐Drug‐Loaded Liposomes: Design Strategies ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/full/10.1002/mba2.70060", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "USFDA approved the first liposomal drug, FDA-approved liposomal drugs, altered organ distribution (heart, liver, and kidney) for liposome-", "score": 0.055336285 }, { "number": 21, "title": "Poster Abstracts", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/pdf/10.1111/fcp.12190", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Physicians have to be aware about the risk of fluid retention and hepatic disorders with imatinib, respiratory disorders with dasatinib and", "score": 0.035320852 }, { "number": 22, "title": "Emergency, Point-of-Care, and Clinical Ultrasound ...", "detail": "www.annemergmed.com", "url": "https://www.annemergmed.com/article/S0196-0644(23)00432-8/abstract", "authors": "www.annemergmed.com", "host": "www.annemergmed.com", "snippet": ". ... 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Ovarian torsion: a fifteen-year review Ann Emerg Med. Diagnosis of ovarian torsion", "score": 0.6496014 }, { "number": 23, "title": "Postoperative complications following gender-affirming vaginoplasty: an acs nsqip study", "detail": "www.ajog.org", "url": "https://www.ajog.org/article/S0002-9378(21)02831-3/pdf", "authors": "www.ajog.org", "host": "www.ajog.org", "snippet": "OBJECTIVES: In November 2016, the American College of Obstetrics and Gynecology (ACOG) released updated clinical guidelines rec-ommending ovarian conservation over oophorectomy for adnexal torsion. Our primary objective was to evaluate trends in the surgical management of adnexal torsion before and ", "score": 0.49699774 }, { "number": 24, "title": "Changing practices in the surgical management of adnexal torsion: an analysis of the national surgical quality improvement project (NSQIP) database", "detail": "www.ajog.org", "url": "https://www.ajog.org/article/S0002-9378(21)02830-1/pdf", "authors": "www.ajog.org", "host": "www.ajog.org", "snippet": "> 1Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA, 2Female Pelvic Medicine and Reconstructive Surgery, University of Michigan, Ann Arbor, MI\n\n# Oral Posters ajog.org \n\nS1282 American Journal of Obstetrics & Gynecology Supplement to MARCH 2022 OBJECTIVES: In N", "score": 0.47051823 } ], "publishedAt": "2026-08-21T00:11:08.630367Z", "updatedAt": "2026-08-21T00:11:08.630367Z", "readingMinutes": 4, "slug": "ovarian-torsion" }