Presentation
Sudden-onset severe right lower quadrant abdominal pain. The pain was accompanied by nausea and vomiting.
Patient Data
The right ovary is heterogenous and midline in position. Adjacent to the ovary, there is a large anechoic, predominantly simple appearing cyst.
Left ovary and uterus are normal in appearance.
Case Discussion
This is a case of ovarian torsion with a serous cystadenoma. The patient initially had an ultrasound which was concerning for right ovarian torsion given the enlarged volume of the right ovary and the presence of a large cystic lesion in the right adnexa.
The patient underwent laparoscopic right ovarian detorsion and ovarian cystectomy. The patient's operative course was complicated by hemoperitoneum due to underlying von Willebrand disease. The patient's hemoglobin continued to decrease despite several packed red blood cell transfusions. The patient returned to the operating room on post-operative day two. She underwent right salpingo-oophorectomy which revealed an edematous fallopian tube and necrotic ovary.
The surgical pathology confirmed serous cystadenoma and extensive acute hemorrhage of ovarian and fallopian tube tissue consistent with torsion.
Co-author:
Ciara Dobrowolski
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