This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. Females have a pair of ovaries, held by a membrane…. “You don’t have another option.”. 2013; 29(4):518-523. Ovarian torsion classically occurs unilaterally in a pathologically enlarged ovary. Our website services, content, and products are for informational purposes only. The diagnosis becomes more challenging in that torsion can occur in female patients of all ages, including infants and the elderly. However, it was noted that body habitus limited the exam. Ovarian torsion should be considered a clinical diagnosis, and a high level of clinical suspicion is needed by the practitioner to ensure that this diagnosis is not missed. American College of Osteopathic Emergency Physicians, Intermittent Ovarian Torsion in Pregnancy, Bilateral Chylothorax Due to Blunt Trauma Without Radiographic Evidence of Traumatic Injury, Phelgmasia Cerulea Dolens Diagnosed by Point-of-Care Ultrasound, The Psychopharmacology of Agitation: Consensus Statement of the American Association for Emergency Psychiatry Project BETA Psychopharmacology Workgroup, Validation of the Social Security Death Index (SSDI): An Important Readily-Available Outcomes Database for Researchers, Combining Ketamine and Propofol (“Ketofol”) for Emergency Department Procedural Sedation and Analgesia: A Review, High School Students’ Perceptions of Motivations for Cyberbullying: An Exploratory Study, Crowding and Delivery of Healthcare in Emergency Departments: The European Perspective, Ultrasound-Assisted Peripheral Venous Access in Young Children: A Randomized Controlled Trial and Pilot Feasibility Study, Nonreciprocal and Reciprocal Dating Violence and Injury Occurrence Among Urban Youth, Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma, Verbal De-escalation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup, A Case of Complicated Urinary Tract Infection: Klebsiella pneumoniae Emphysematous Cystitis Presenting as Abdominal Pain in the Emergency Department, The Clinical Differentiation of Cerebellar Infarction from Common Vertigo Syndromes, Fatal Metformin Overdose Presenting with Progressive Hyperglycemia, The Standard of Care: Legal History and Definitions: the Bad and Good News, Paget-Schroetter Syndrome: Review of Pathogenesis and Treatment of Effort Thrombosis, Wide Complex Tachycardias: Understanding this Complex Condition Part 2 - Management, Miscellaneous Causes, and Pitfalls, Kaiser Permanente San Diego Medical Center, Department of Emergency Medicine, San Diego, California, Kaiser Permanente San Diego Medical Center, Department of Obstetrics and Gynecology, San Diego, California. Teens who see a pediatrician for nausea, vomiting, and pain in the pelvic area run the risk of being misdiagnosed with appendicitis or gastroenteritis. MANAGEMENT OF INTERMITTENT OVARIAN TORSION BY LAPAROSCOPIC OOPHOROPEXY Michelle Gemain, MD, Thomas Rarick, MD, and Edwin Robins, MD Backgrowd Ovarian torsion is a serious gynecologic condi- tion that often results in adnexal removal. Waiting puts you at risk for cutting off the blood supply to the torsed ovary. If recurrent, this can result in castration of young patients. Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. Regarding Doppler flow, one study found that 61% of ovarian torsion on the right had normal doppler flow while 27% on the left had normal flow. Symptoms typically include pelvic pain on one side. WestJEM Articles by Richmond et al. However, the presence of enhancement does not exclude torsion because a twisted ovary, with its redundant blood supply, can appear to enhance normally, presumably because the torsion is intermittent or of recent onset . Objective: To describe an additional maneuver during sonography for ovarian torsion and to assess its diagnostic value. When the physical examination is not congruent with the level of patient distress, ischemic pain from an ovarian torsion must be considered. Here are eight different picks of the best deodorants…, Research hasn’t shown that creatine directly causes hair loss. At the time of the repeat US the right ovary measured 8.23 cm × 8.41 cm × 5 cm, whereas the left ovary was 2.22 cm × 2.94 cm × 3.22 cm. Many people feel anxious when they are hungry. A twisted pedicle, although not often detected on imaging, is … No masses, distention or tenderness were detected. 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