Torsion of a Normal Ovary During the Early Postpartum Period

Abstract

Ovarian cyst torsion is a well-known cause of acute abdominal pain in female patients. However, torsion of a normal ovary is extremely rare and predominantly occurs in premenarchal female patients. The objective of this report is to describe a rare case of acute abdomen during the early postpartum period that was ultimately diagnosed as torsion of a normal ovary by laparoscopic surgery. A 29-year-old woman vaginally delivered a healthy 3530-g baby uneventfully at 40 weeks' gestation. On postpartum day 6, she presented with acute abdominal pain in the right lower quadrant and costovertebral angle tenderness. A complete workup including laboratory examination, ultrasonography, and computed tomography was performed. Leukocytosis with a left shift and a slightly enlarged right ovary were found. Finally, diagnostic laparoscopy showed torsion of a normal ovary. The patient underwent laparoscopic detorsion of the right adnexa and was discharged on postoperative day 4 without any complications.

Ovarian Torsion Due to Mature Cystic Teratoma During the Early Postpartum Period: A Rare Case Report

“…Although the incidence of torsion decreases as the gestational age increases, it can also occur at any time of pregnancy or in the postpartum period. 7 In this present case, torsion due to the mass occurred in the early postpartum period. This can be interpreted as vaginal delivery triggering ovarian torsion.…”

“…For this reason, imaging methods are often needed to make the appropriate treatment and to make a diagnosis. [6][7][8][9] Various tumor markers have increased depending on the component tissues of ovarian germ cell tumors, including MCT. Elevated serum tumor marker levels may serve as an adjunct in initial diagnosis, therapy monitoring, and posttreatment surveillance.…”

Torsion of a Large Ovariancyst during the Postpartum Period: A Case Report from the Niger-Turkey Friendship Hospital in Niamey

“…Other diagnoses may be suggested depending on the time of discovery. In the case of a small volume, the diagnoses evoked may be adnexal abscess, endometritis, thrombosis of an ovarian vein, retroperitoneal hematoma, appendicitis, intestinal obstruction, urinary lithiasis and urinary tract infection [9]. Our patient the torsion had occurred two weeks postpartum.…”

“…Our patient the torsion had occurred two weeks postpartum. On the etiopathogenic level, in postpartum the displacement of the adnexa secondary to the physiological involution of the uterus and the relaxation of the supporting tissues, by a disproportionate stretching of the ligaments, increase the mobility of the mass and the risk of adnexal torsion [9]. There are two etiopathogenic entities: either the adnexal mass pre-exists pregnancy, or it appears and develops during pregnancy or postpartum.…”

Torsion of normal adnexa in a 31-year-old woman: A case report and literature review

“…Adnexal torsion accounts for 3% of gynecologic surgical emergencies,[ 5 ] but this is sometimes underestimated. Excessive conservative management can cause ovarian necrosis.…”