Hello and welcome to the Zero to Finals podcast.

My name is Tom, and in this episode, I'm going to be talking to you about ovarian torsion.

And if you want to find written notes on this topic, you can find them at zero definals.com

slash ovarian torsion or in the gynecology section of the zeroed finals, obstetrics and gynecology book.

So let's get straight into it.

Ovarian torsion is a condition where the ovary twists in relation to the surrounding connective tissue, fallopian tube and blood supply.

And the connective tissue, fallopian tube and blood supply together are called the

adenexia. Ovarian torsion is usually due to an ovarian mass larger than five centimeters,

such as a cyst or a tumour. It's more likely to occur with benign tumors. It's also more likely

to occur during pregnancy. Ovarian torsion can happen with

normal ovaries in young girls before menache, before their first period. And this is because

girls before their first period, before puberty, have longer infundibulopelic ligaments that hold the

ovaries in place, and this means the ovary

can twist more easily. Twisting of the adenexia and the blood supply to the ovary leads to

ischemia. If the tors, necrosis will occur and the function of that ovary will be lost.

Therefore, ovarian torsion is an emergency where a delay in treatment

can have significant consequences. Prompt diagnosis and management is essential. So how does it present?

The main presenting feature is sudden onset, severe, unilateral pelvic pain.

Typically, the pain is constant, gets progressively worse and is associated with nausea and vomiting.

The pain is not always severe and ovarian torsion can take a milder and more prolonged course.

Occasionally the ovary can twist and then untwist intermittently,

causing pain that comes and goes.

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