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Case Reports
. 2021 Apr 30;16(7):1646-1649.
doi: 10.1016/j.radcr.2021.03.040. eCollection 2021 Jul.

Ovarian torsion after hysterectomy and oophoropexy

Chris Bent  1 , Bryon Thomson  1 , Monika Kief-Garcia  1
Affiliations
Case Reports

Ovarian torsion after hysterectomy and oophoropexy

Chris Bent et al. Radiol Case Rep. .

Erratum in

Abstract

Ovarian torsion (OT) is a medical emergency which can have significant clinical consequences. It is surgically treated by either detorsion with or without oophoropexy, or oophorectomy. In this report, a case of left OT is described after prior hysterectomy and bilateral prophylactic oophoropexy three years prior. The patient presented with progressive left flank and abdominal pain. The diagnosis of torsion was made using a combination of CT and MR imaging with confirmation at surgery and pathology. At laparoscopic surgery, the left ovary was found at the level of iliac crest posterior to the descending colon. The ovary was torsed with hemorrhagic infarction. It was successfully removed. The patient was discharged postoperative day one and is now free of symptoms and complaints. OT is rarely reported after hysterectomy and oophoropexy. This case demonstrates that OT should be kept in the differential even in patients post hysterectomy and/or oophoropexy.

Keywords: Hysterectomy; Oophorectomy; Oophoropexy; Ovarian torsion; Ovaripexy.

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Figures

Fig 1
Fig. 1
(A) Axial post IV contrast CT image through the pelvis demonstrating small volume free fluid (red arrow) with HU 35 concerning for hemoperitoneum. (B). Axial post IV contrast CT image at the level of the iliac crest demonstrating enlarged left ovary (blue arrow) posterior to the descending colon with adjacent periovarian edema (yellow arrows) (C). Coronal post IV contrast CT image through the abdomen and pelvis demonstrating the enlarged left ovary (blue arrow), periovarian edema (yellow arrow), and normal contralateral right ovary is visualized for comparison (white arrow).
Fig 2
Fig. 2
(A) Axial fast spin echo MR sequence through the abdomen demonstrating the enlarged left ovary (blue arrow). Note the peripheral follicles. Edema is again demonstrated in the adjacent retroperitoneum (yellow arrow). (B). Coronal fast spin echo MR sequence through the abdomen demonstrating the enlarged left ovary (blue arrow). Note the peripheral follicles. Normal contralateral right ovary is visualized for comparison (white arrow). (C). Axial T1 weighted subtraction image through the ovarian mass (white asterisk) demonstrating no post contrast enhancement of the ovary.
See this image and copyright information in PMC

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