History and exam
Key diagnostic factors
common
abdominal or pelvic pain
Acute lower abdominal pain that is usually intermittent or fluctuating.[1]
May be localized to either side or diffuse, and may sometimes radiate to the back, flank, or groin.
nausea, vomiting, or diarrhea
Nonspecific but common presenting symptom of ovarian torsion.[1]
abdominal/pelvic tenderness
Location may be localized, diffuse, or adnexal.
Other diagnostic factors
common
feeding intolerance, vomiting, abdominal distention, and fussiness (neonates)
In the neonatal period, ovarian torsion may present a diagnostic challenge, due to the neonate's inability to communicate.
uncommon
strenuous exercise
Sudden physical movements may cause increase in abdominal pressure and push the ovary to rotate on its pedicle.[24]
peritoneal signs
In women undergoing laparoscopy for suspected ovarian torsion, rebound has been reported in 14% of cases, and guarding reported in 18% of cases.[26]
cervical motion tenderness
Uncommon, but may be a presenting sign.
fever
Uncommon, but may be a presenting sign.
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