Torsion of an Ovarian Endometrioma: About an Uncommon Case Report

Endometrioma, when its size is ≥ 5 cm, can be complicated by a torsion of the ovary. In this case it is a diagnostic and therapeutic emergency with respect to the many complications of ovarian torsion including necrosis. We report a case of endometrioma diagnosed by a torsion of the ovary. The context clinic was dominated by acute pelvic pain; the ultrasound showed a huge left cystic ovary, and the laparotomy revealed a torsion of the left adnexa. A detorsion and cystectomy was performed and the confirmation of the endometrioma was provided by the histology of the surgical specimen. The difficulty lies in the diagnostic and therapeutic choice to preserve or not the ovary. The indications are therefore discussed on a case-by-case basis and depend on many parameters, the most important of which is the intraoperative viability of the ovary after its detorsion.