Torsion of Ovarian Endometrioma: A Case Report

Kôtaro Oshima, S. Baba, Ayane Maki, Kana Tamai, Kohei Yamaguchi, M Morioka, Katsuyuki Adachi, Toshio Igarashi
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2024 · vol. 40(1) , pp. 200–204 · doi:10.5180/jsgoe.40.1_200 · W4402030286
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

Ovarian endometrioma torsion can cause acute abdominal pain, particularly in adolescent females with weak adhesions, and palliative treatment in these cases may negatively impact ovarian function.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This 2024 case report describes an adolescent (17-year-old) with severe acute abdominal pain, previously known to have a left ovarian endometrioma that increased in size (from 7 cm to 10 cm) during the interval before planned laparoscopic surgery. The authors performed emergency laparoscopic surgery after diagnosing ruptured endometrioma and found the endometrioma mildly adherent to the broad ligament and twisted 180° counterclockwise around the adhesion axis and the tubal ligament; postoperative pain relief was reported. The report discusses the broader literature and notes a key caveat that while acute pain is often linked to rupture, torsion can occur in patients with weak adhesions and that “palliative” approaches in such contexts may impair ovarian function. This paper is centrally about endometriosis — it focuses on torsion of an ovarian endometrioma in an adolescent and its surgical management.

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Abstract

In general, acute abdominal pain due to ovarian endometrioma is strongly associated with ovarian cyst rupture, as a result of adhesions to tissues around the cyst, especially the broad ligament. Therefore, the choice between surgery or palliative treatment may be difficult. However, torsion of endometrioma can occur, especially among adolescent females with weak adhesions, and palliative treatment in such situations can impair ovarian function.
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Case report Torsion of Ovarian Endometrioma: A Case Report 2024 Volume 40 Issue 1 Pages 200-204 Details Abstract In general, acute abdominal pain due to ovarian endometrioma is strongly associated with ovarian cyst rupture, as a result of adhesions to tissues around the cyst, especially the broad ligament. Therefore, the choice between surgery or palliative treatment may be difficult. However, torsion of endometrioma can occur, especially among adolescent females with weak adhesions, and palliative treatment in such situations can impair ovarian function. Here, we describe a case in which torsion of ovarian endometrioma developed in an adolescent female, and we discuss the relevant literature. A 17-year-old female presented with severe abdominal pain. We previously demonstrated that she had a left ovarian endometrioma with a diameter of 7 cm, and planned laparoscopic surgery after magnetic resonance imaging evaluation. At that time, the area of her pain was consistent with left ovarian endometrioma, and its diameter subsequently increased to 10 cm. We diagnosed ruptured endometrioma, and performed emergency laparoscopic surgery. The left ovarian endometrioma with mild adhesions to the broad ligament was found to be twisted 180° counterclockwise around the axis of the point of adhesion and the tubal ligament. Postoperatively, the patient’s pain was relieved, and she is now receiving a prophylactic course of low-dose oral contraceptive medication. In this case, we performed surgery due to the patient’s severe abdominal pain, and if we had not, her left ovarian function would have been impaired. Torsion of endometrioma should be considered in the differential diagnosis of acute abdominal pain in adolescent females. © © 2024 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy Favorites & Alerts Recently viewed articles

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endometrioma

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