Torsion of ovarian endometrioma in pregnancy: a case report and review of the literature

Dingchao Hua, Hua D, Peng Zhao, Jiang L, Lianyun Jiang
Tropical doctor · 2019 · vol. 49(3) , pp. 221–223 · doi:10.1177/0049475519847327 · PMID:31067205 · W2944598248
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This case report and literature review describes the successful surgical management of ovarian endometrioma torsion in an early-term pregnancy, highlighting diagnostic and therapeutic challenges.

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Abstract

Adnexal torsion induced by an endometrioma has seldom been reported. Because of its rarity and its complexity in respect of fetal health during pregnancy, the diagnosis and treatment is challenging. We report a 25-year-old primigravida in the eighth week of gestation presenting with acute onset lower abdominal pain. A pelvic ultrasonography showed an intrauterine single viable embryo with a right ovarian cyst measuring 6 × 6 cm in diameter. Exploratory laparotomy revealed torsion of the right adnexa by 360°. After a right adnexectomy was performed, the patient proceeded to full-term pregnancy. Adnexal torsion is defined as rotation of > 45° in the long axis of the adnexae. Its occurrence during gestation is reported as 2%, accounting for 2.7% of surgical emergencies in pregnant women. Most cases are caused by dermoid and functional ovarian cysts. Because of the rarity of torsion induced by an endometrioma, the diagnosis and treatment are challenging. In poor-resource conditions, a diagnostic laparoscopy (or laparotomy) remains a logical method of diagnosis, offering simultaneous therapeutic options.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Endometriosis Ovarian Diseases Pregnancy Complications Torsion Abnormality Abdominal Pain Abdominal Pain Adult Emergencies Endometriosis Female Humans Ovarian Diseases Ovarian Diseases Pregnancy Pregnancy Complications Pregnancy Complications Torsion Abnormality Torsion Abnormality Ultrasonography

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (5)

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