Ovarian Torsion
Twisting of the ovary and tube on their vascular pedicle occludes venous outflow first and then arterial inflow, so the ovary congests and infarcts.
Definition
Ovarian torsion is partial or complete rotation of the ovary, usually with the fallopian tube, around its vascular pedicle. It obstructs venous and lymphatic outflow first, then arterial inflow. There are no diagnostic criteria: no imaging or blood test confirms or excludes it, and the diagnosis is made clinically and confirmed at laparoscopy.
First principles
There is no UK national guideline for ovarian torsion
No Royal College of Obstetricians and Gynaecologists (RCOG) Green-top Guideline covers ovarian or adnexal torsion. Green-top Guideline No. 62 on suspected ovarian masses is a 2011 first edition, and it says in terms that it does not address the acute presentation. Its entire torsion content is one clause in section 4.1. What exists instead is local NHS board guidance and one paediatric society guideline. The principal UK review, in The Obstetrician and Gynaecologist, sits behind a publisher paywall and could not be read for this chapter. Treat what follows as the best readable UK practice, not as national policy.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.