Adnexal Torsion

Adnexal torsion is a painful condition that affects the female reproductive system, specifically the ovaries and fallopian tubes. It occurs when these structures twist around their supporting ligaments, cutting off their blood supply. This twisting can cause sudden, severe pelvic pain and may lead to damage or loss of the affected ovary if not treated promptly. The condition most commonly affects women of reproductive age and can be associated with ovarian cysts or masses. Early recognition is important because prolonged loss of blood flow can cause tissue death and impact fertility. Symptoms often include nausea, vomiting, and localized tenderness. Diagnosis and treatment usually require urgent medical evaluation.

Adnexal torsion is the partial or complete twisting of the ovary and/or fallopian tube around the infundibulopelvic ligament or utero-ovarian ligament, leading to compromised vascular supply. The primary mechanism involves venous and lymphatic obstruction initially, followed by arterial ischemia if untreated, resulting in ovarian edema, hemorrhage, and necrosis. It is most commonly caused by an ovarian mass or cyst that increases the ovary's mobility. Clinically, it presents with acute onset of unilateral lower abdominal or pelvic pain, often accompanied by nausea and vomiting. It is a gynecologic emergency due to the risk of ovarian infarction and loss of reproductive function. Diagnosis is challenging and relies on a combination of clinical suspicion and imaging findings. Prompt surgical intervention is critical to preserve ovarian viability.