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Ovarian torsion is a gynecological emergency involving complete or partial rotation of the ovary around its vascular pedicle, leading to compromised blood flow. This condition most commonly affects women of reproductive age and requires immediate surgical intervention to prevent ovarian necrosis and preserve fertility.
Torsion occurs when the ovary twists around the ovarian ligament and fallopian tube, causing venous outflow obstruction followed by arterial compromise. Initially, venous return is impaired while arterial inflow continues, leading to ovarian enlargement, edema, and eventual ischemic necrosis if untreated within 6-8 hours.
Diagnosis requires high clinical suspicion as symptoms mimic other acute abdominal conditions, with sudden-onset severe unilateral pelvic pain being the hallmark presentation. Doppler ultrasound showing absent or decreased ovarian blood flow supports the diagnosis, though normal flow doesn't exclude torsion, necessitating urgent laparoscopic detorsion and oophoropexy to salvage ovarian function.