“… 34 Ovarian asymmetry can be the first clue of ovarian torsion, with a 50% increase in ovarian volume compared to the unaffected side highly specific for ovarian torsion in premenarchal girls. 35 A recent series of pediatric patients found a median 5.57X difference in volume between affected and unaffected ovaries. 14 Figure 3 A torsed ovary in a medial location.…”
Section: Point-of-care Ultrasoundmentioning
confidence: 99%
“…The ovary has a dual blood supply and presence of flow to an edematous ovary can be seen in early or incomplete torsion and a torsed ovary can present with normal arterial flow in almost one-third of cases. 14 , 35 , 41 , 42 Prieto et al report that only 38% of torsed ovaries were found to have lack of Doppler flow. 6 …”
Ovarian torsion is defined as twisting of the ovary around an axis consisting of its vascular pedicle, the infundibulopelvic ligament and the tubo-ovarian ligament, and can occur in females of any age. Torsion can be a result of ovarian mass causing asymmetry and subsequent torsion, or can be spontaneous. While ovarian torsion is a surgical emergency, early diagnosis and treatment can preserve ovarian viability even if necrosis is seen operatively. Presentation classically involves sudden onset severe abdominal pain and vomiting but diagnostic delay can follow subtler presentations. Diagnosis is most commonly based on sonographic findings, but advanced imaging such as CT or MRI may be required if sonography is not diagnostic. Treatment is surgical, with ovarian preservation preferred in almost all cases. In this review, I present the most recent evidence on epidemiology, diagnosis, and management of pediatric ovarian torsion, with a focus on point-of-care ultrasound for the emergency care provider.
“… 34 Ovarian asymmetry can be the first clue of ovarian torsion, with a 50% increase in ovarian volume compared to the unaffected side highly specific for ovarian torsion in premenarchal girls. 35 A recent series of pediatric patients found a median 5.57X difference in volume between affected and unaffected ovaries. 14 Figure 3 A torsed ovary in a medial location.…”
Section: Point-of-care Ultrasoundmentioning
confidence: 99%
“…The ovary has a dual blood supply and presence of flow to an edematous ovary can be seen in early or incomplete torsion and a torsed ovary can present with normal arterial flow in almost one-third of cases. 14 , 35 , 41 , 42 Prieto et al report that only 38% of torsed ovaries were found to have lack of Doppler flow. 6 …”
Ovarian torsion is defined as twisting of the ovary around an axis consisting of its vascular pedicle, the infundibulopelvic ligament and the tubo-ovarian ligament, and can occur in females of any age. Torsion can be a result of ovarian mass causing asymmetry and subsequent torsion, or can be spontaneous. While ovarian torsion is a surgical emergency, early diagnosis and treatment can preserve ovarian viability even if necrosis is seen operatively. Presentation classically involves sudden onset severe abdominal pain and vomiting but diagnostic delay can follow subtler presentations. Diagnosis is most commonly based on sonographic findings, but advanced imaging such as CT or MRI may be required if sonography is not diagnostic. Treatment is surgical, with ovarian preservation preferred in almost all cases. In this review, I present the most recent evidence on epidemiology, diagnosis, and management of pediatric ovarian torsion, with a focus on point-of-care ultrasound for the emergency care provider.
“…However, age-specific normal values for ovarian size are not well established. Ovarian asymmetry can be the first clue of ovarian torsion, and a 50% increase in ovarian volume compared with the unaffected ovary is highly specific for ovarian torsion in premenarchal girls 9 . Echogenicity can be asymmetric as well: venous congestion and ischemia lead to edema and hemorrhage, causing increased echogenicity in the torsed ovary when compared with the healthy ovary.…”
Section: Techniquementioning
confidence: 99%
“…There is controversy regarding the utility of Doppler flow in the evaluation of ovarian torsion, as absence of flow may be due to sonographer inexperience, and presence of flow to an edematous ovary, given the dual ovarian blood supply, can be seen in early or incomplete torsion. With Doppler sonography, a torsed ovary can present with normal arterial flow in almost one third of cases 9,14 . Prieto et al 2 report that only 38% of torsed ovaries were found to have lack of Doppler flow.…”
Section: Techniquementioning
confidence: 99%
“…Ovarian asymmetry can be the first clue of ovarian torsion, and a 50% increase in ovarian volume compared with the unaffected ovary is highly specific for ovarian torsion in premenarchal girls. 9 Echogenicity can be asymmetric as well: venous congestion and ischemia lead to edema and hemorrhage, causing increased echogenicity in the torsed ovary when compared with the healthy ovary. The follicular ring sign, indicating perifollicular edema, is an early indication of torsion 10 and can be seen in Figure 1.…”
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
