An interesting case of Right ovarian Torsion

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 33 year old P1L1 with previous NVD came to emergency with Acute abdomen since 1 day not relieving on medications radiating to back and associated with vomitings .

Known case of hypothyroidism since 3 mnths on T.thyronorm 25 mcg 

History of appendicectomy 13 years ago 

Menstrual history: Irregular cycles, 3 months once 

LMP 19/5/2024

LCB 6 years ago

Per abdomen: 

Soft, Tenderness present in Right lumbar region 

Appendectomy scar +

Bimanual examination: 

Uterus 8 weeks size ,AV,soft uterus , Fornices free, No tenderness 

UPT negative on admission 

CA 125 - 9 U/ml

S.TSH 3.2 uIU/ml

USG Pelvis :

Ut 76 x 32x 47 mm AV 

ET 5mm

Ovaries:

Right ovary: 60x32x58mm bulky with peripherally arranged follicles and echogenic centre with no colour uptake on Doppler.Mildfluid noted in POD adjacent to right ovary suggestive of Right ovarian torsion.

Left ovary normal 

Mild free fluid noted in POD 

Planned for Right ovarian Detorsion with right oophoropexy










with right ovarian cyst aspiration

Intraoperative findings:

1. Torsion of right ovary with 1 twist, detorsion done.

2. Right ovary multicystic 6x4x5 cm 

3.Tubal viability present.

4. Haemorrhagic follicles ruptured and aspirated 

5.Size of ovary reduced 

6.oophoropexy done 

7.Ovarian ligament and round ligament sutured with silk

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