What should you know?
Ovarian torsion occurs when the ovary twists around its supporting vessels and compromises blood flow. It is an emergency in which rapid assessment improves the chance of preserving ovarian tissue.
Risk rises with an ovarian cyst or enlarged ovary, pregnancy and ovulation stimulation. Intermittent twisting can cause episodes that temporarily improve.
Common symptoms and signs
- Sudden severe one-sided pelvic or lower abdominal pain
- Nausea and vomiting
- Marked tenderness or recurrent attacks
- Known ovarian cyst or recent stimulation
Diagnosis and the role of ultrasound
Ultrasound assesses ovarian enlargement, edema, follicle distribution, cysts, free fluid and Doppler flow. Normal arterial flow does not completely exclude torsion when symptoms are convincing.
- Enlarged edematous ovary
- Peripheral follicles
- Venous and arterial flow
- Possible twisted vascular pedicle
Ultrasound findings must be interpreted together with symptoms, examination and, when needed, laboratory or other imaging results. An image alone should not be used for self-diagnosis or self-treatment.
Treatment and next steps
High clinical suspicion requires immediate gynecologic or surgical review. Definitive diagnosis and treatment are often laparoscopic; temporary pain relief does not rule torsion out.
Management is individual and depends on age, symptoms, imaging findings, other health conditions and pregnancy plans. Medication or a procedure should be selected with the appropriate clinician.
When is urgent care needed?
- Sudden one-sided pain with nausea or vomiting
- Severe pain with a known ovarian cyst
- Pain during pregnancy or after fertility stimulation
Related reading
- Ovarian cyst — symptoms, diagnosis and treatment
- Follicle monitoring — when is it ordered and how is it performed?
- Ectopic pregnancy — how does it appear on ultrasound?
When should you consult radiologist Lana Ezieshvili?
Radiologist Lana Ezieshvili performs targeted ultrasound examinations, describes findings using standard imaging criteria and explains the report in clear language.
If you have symptoms, a referral or need follow-up imaging, use the form below to book a visit with Lana Ezieshvili. Timely, appropriately selected imaging can reduce uncertainty and help determine the right next step.
This article is for education and does not replace medical advice. Seek urgent care for severe or rapidly worsening symptoms.