To familiarize radiologists with the multiple stages and potential causes of adnexal torsion,
focusing on differences in imaging that allow for proper diagnosis.
Review of Adnexal Anatomy The broad ligament (Figure 1) is a peritoneal fold that attaches the ovaries,
and uterus to the pelvic sidewall and floor.
It is divided into three main sections,
named after the adjacent structure: the mesovarium (ovaries),
mesosalpinx (fallopian tubes),
and mesometrium (uterus).
The ovaries are also supported by the ovarian ligaments (sometimes referred to as the utero-ovarian ligaments) connecting them to the uterus.
The ovarian vessels are...
Findings and procedure details
Presentation/Acuity Symptoms of acute onset ovarian/adnexal torsion include moderate to severe pelvic or lower abdominal pain,
often of sudden onset,
which may be sharp,
or colicky in quality.
The pain may radiate to the flank,
Patients may also exhibit nausea and vomiting.
After hemorrhage occurs,
patients may also present with vaginal bleeding.
fever and peritoneal signs may indicate the presence of necrosis.
Laboratory values of anemia and leukocytosis may...
A detailed knowledge of the possible mechanisms and stages of adnexal torsion allows the radiologist to provide more accurate and clinically relevant findings to referring physicians.
MD Westchester Medical Center Valhalla,
 Oltmann SC,
Cannot exclude torsion--a 15-year review.
J Pediatr Surg.
2009;44(6):1212-6.  Tsafrir Z,
Adnexal torsion: cystectomy and ovarian fixation are equally important in preventing recurrence.
Eur J Obstet Gynecol Reprod Biol.
2012;162(2):203-5.  Comerci G,
Isolated fallopian tube torsion: a rare but important event for women of reproductive...