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Age: 19

Sex: Female

Indication: Right lower quadrant pain, negative pregnancy test

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Case #43


Findings

  • Right ovary is asymmetrically enlarged and hyperemic relative to the left ovary with peripheralized follicles
  • Normal appearance of the uterus with IUD in its expected location
  • Small volume free fluid layering in the cul-de-sac


Diagnosis

Ovarian torsion-detorsion

Sample Report

Asymmetrically enlargement and hyperemia of the right ovary with peripheralized follicles, which in the context of right lower quadrant pain raises concern for ovarian torsion-detorsion. Recommend evaluation by gynecology.

Small volume free fluid layering in the cul-de-sac.


Discussion

  • Remember that the presence of blood flow within an ovary does not exclude torsion – an asymmetrically enlarged ovary in the context of pain is worrisome in and of itself
  • A recently torsed ovary may be transiently hypervascular following spontaneous detorsion
  • Make sure to also look for the appendix in these cases as it may pass in close proximity to the right ovary



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