Torsion of the ovary: a known but frequently missed diagnosis

Torsion of the ovary or fallopian tube is a rare acute gynaecological disorder, seen by different medical specialists. The diverse clinical presentation is one of the main reasons this diagnosis is frequently missed at first presentation. For the preservation of ovarian function it is of utmost importance to diagnose an ovarian torsion at an early stage. We will describe the medical history of three patients with a torsion of one of the ovaries to illustrate the variety of clinical presentation. A medical history of pelvic operations or enlarged ovaries often predisposes to torsion of the ovary or fallopian tube. Treatment policy will differ depending on the stage of life. Ovariopexy can be considered to prevent the ovary from torsion and to maintain its function. Torsion of the ovary is an acute gynaecological disorder with an incidence of 3% in a series of acute gynaecological complaints. It is a disorder in which the ovary and the fallopian tube can be affected, combined as well as separated. Although every specialist is familiar with the disorder, the diagnosis in acute presentation is frequently missed. To bring this entity and its great variability in clinical presentation into focus once again, we will highlight three patients out of a series of 13. Furthermore, we will discuss the possible causes of the disorder and present a proposition for treatment. European Journal of Emergency Medicine 16:124-126 (C) 2009 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.