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Torsion of the ovary (appendages) is difficult to recognize as it gives non-specific symptoms that may suggest diseases of the urinary or digestive system. What are the causes of ovarian torsion? How do I recognize my symptoms? What is the treatment? Can ovarian torsion lead to infertility?

Ovarian torsionis actually a torsionof appendages , i.e. ovaries and fallopian tubes. The torsion of the ovary itself or the fallopian tube is rare. As a result of torsion, blood supply to the ovaries and fallopian tubes is completely inhibited, which may lead to their necrosis and subsequent loss.Appendicular torsionaffects mainly women of childbearing age, although it can also occurin childrenand menopausal women.

Torsion of the ovary (appendages) - causes

  • excessively long fallopian tube
  • elongated mesentery of the fallopian tube, ovary
  • elongated ovarian ligaments
  • ovarian tumors
  • ovarian cysts
  • tubal hydrocele
  • ovarian cysts

Torsion of the ovary (appendages) - symptoms

  • sudden, sharp, often one-sided (usually on the right) pain in the lower abdomen
  • nausea and vomiting
  • diarrhea
  • increased body temperature

Symptoms of ovarian torsion are not specific and may indicate diseases of the urinary and digestive systems. The pain that accompanies ovarian torsion can radiate to the back (like acute pancreatitis), pelvis and thigh (mimicking renal colic). Ovarian torsion most often occurs on the right side and may therefore be misdiagnosed as appendicitis. Other diseases of the digestive system that may be mistaken for ovarian torsion include diverticulitis of the colon, intestinal obstruction.

Torsion of the ovary (appendages) - diagnosis

The doctor interviews the patient and performs a palpation examination, during which you can feel a tender mass in the lower abdomen. In addition, blood tests, urinalysis and imaging (ultrasound and Doppler ultrasound of the pelvis) are necessary.

Worth knowing

Ovarian torsion in pregnancy

The risk of torsion of the appendages in pregnancy is very small, but the stimulation of ovulation in the cycles that immediately precede pregnancy may be responsible for almost half of allpregnant cases.

Torsion of the ovary (appendages) - treatment

If the appendages are twisted, an operation should be performed to unscrew them as soon as possible. Further management depends on the cause of the appendage torsion. For example, in the case of an ovarian cyst, the lesion is removed from the ovary a few weeks after the operation.

Postmenopausal patients, due to the increased risk of concomitant malignant changes, should be offered the removal of entire appendages.


The time from the onset of pain to surgery is important to maintain ovarian function. The best treatment results are achieved when they are started up to 48 hours after the onset of pain.

Torsion of the ovary (appendages) - complications

If diagnosed late, long-term complications such as decreased ovarian reserve may develop, resulting in less chance of pregnancy and recurrent abnormal lower abdominal pain.

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