Adnexal torsion may involve the ovary and/or the corresponding fallopian tube . Possible risk factors include ovulation
induction in preparation for assisted reproduction , pregnancy (especially during the early stages), and an increase in ovary size of more than 4-6 cm (often associated with the presence of ovarian masses of neoplastic nature).
Favorable conditions may also be the presence of an ovarian cyst (especially if solid), hydrosalpinx, tubal ligation and previous surgical operations which increase the mobility of the annexes.
Frequently, pain associated with adnexal torsion occurs or ceases after sudden body movements. Furthermore, it can radiate posteriorly to the back, laterally and to the thigh.
The presence of recurring ovulatory pain may be a sign of spontaneously resolved episodes of torsion favored by the increase in secretions and tubal motility. In these cases, the pain is usually colicky and intermittent. Adnexal torsion can cause peritonitis and delay in surgery can lead to irreversible damage to the tube and/or ovary.
Usually, the diagnosis is confirmed by transvaginal color Doppler ultrasound . Often, there are also signs of peritoneal irritation, tenderness on cervical mobilization , and the presence of a unilateral adnexal mass.
The therapy can be made use of a laparoscopic or laparotomic intervention of conservative detorsion. Salpingo- oophorectomy is necessary in the presence of extensively ischemic or necrotic tissue.
Symptoms And Signs Of Adnexal Torsion
Adnexal torsion is characterized by the presence of several symptoms that can include:
Common Symptoms Of Adnexal Torsion
- Acute Abdomen
- Abdominal pain
- Abdominal pain on palpation
- Pain in the ovaries
- Pelvic pain
Rarer Symptoms Of Adnexal Torsion
- Sore legs
- Painful ovulation
- Barrel chest
- Eye fatigue
- Fatigue with spasms (spasmophilia)
- Hemolytic uremic syndrome
- Irritable bowel syndrome
- Hiatal hernia