Ovarian Torsion: The Daily PANCE Blueprint

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Ovarian Torsion: The Daily PANCE Blueprint

A 25-year-old female with no past medical history presents with nausea, emesis, and pelvic pain. She is normotensive, afebrile, and slightly tachycardic (HR 102 bpm). On physical exam, you palpate an ovarian/pelvic mass. Beta-hCG is negative. The pelvic US is pending. Which of the following is the most likely diagnosis?

A. Ectopic pregnancy
B. Appendicitis
C. Pelvic inflammatory disorder
D. Ovarian torsion
E. Placenta abruption

Answer and topic summary

D. Ovarian torsion

Ovarian torsion refers to the rotation of the ovary, often leading to complete or partial obstruction of blood supply. The most common predisposing factor is an ovarian mass. Presenting features include pelvic pain (90%), nausea, emesis, and fever. On physical exam they may have pelvic and/or abdominal tenderness. A pelvic ultrasound is the mainstay of evaluation when ovarian torsion is suspected. You can get a beta-hCG to rule out an ectopic pregnancy. The definitive diagnosis is made by directly visualizing a rotated ovary at the time of surgical evaluation. Surgery and OB-GYN should be consulted for further management.

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Covered under ⇒ PANCE Reproductive System Blueprint ⇒ Ovarian Torsion

Also covered as part of the Women's Health PAEA EOR topic lists