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.

palpable adnexal mass

Results from two small retrospective chart reviews suggest that palpable adnexal mass may be felt on examination in roughly 43% to 53% of cases due to enlarged adnexa.[26][27]

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.

Use of this content is subject to our disclaimer