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Ovarian Torsion : Doppler Ultrasound

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This young female patient presented with 1 day history of left lower quadrant pain and vomiting. Color doppler ultrasound shows a normal follicular pattern and blood flow in the right ovary. The left ovary shows a small hemorrhagic cyst, few tiny peripheral follicles, no arterial or venous flow, and a twisted pedicle just cranial to the ovary, confirming the diagnosis of ovarian torsion.

The involved ovary is usually tender to transducer pressure. The absence of ovarian Doppler flow is highly specific for torsion, but normal Doppler flow does not completely exclude it. An ovarian mass causing the torsion must always be sought.

Case courtesy of Dr Maulik S Patel, Radiopaedia.org. From the case rID: 28924

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