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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

A Journal on Internal Medicine and Pharmacology


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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2013 December;172(12):957-61

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Bilateral asynchronous adnexal torsion in a young fertile woman: an unusual case

Algeri P. 1, Visconti A. 2, Ermito S. 2, Rinaldo D. 2, Clemente F. 2, De Tommaso A. 2, Algeri M. 2

1 Department of Medicine and Surgery, Milano-Bicocca University Monza e Brianza, Italy; 2 Unit of Obstetrics and Gynecology P.O.A. Locatelli, Bolognini Ospital Piario, Bergamo, Italy


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The ovarian torsion, a rare gynecological disease interesting usually young and fertile women, is specially unilateral, but rarely it affects both adenexals. This disease is considered a gynecological emergency because a diagnostic delay could permanently compromise the interested ovary. The pathogenic mechanism is not already clear, but the torsion is frequently correlated with other adnexal alterations. The symptoms of torsion are abdominal pain, adnexal mass and peritonitis, but they are unspecific and unfortunately most patients do not present them. The definitive diagnosis needs imaging to be posed: ultrasound, especially with a Doppler valuation, is one of the most accurate examination to define this disease. The therapy includes the possibility to a conservative ovarian de-torsion. If the ovary had no vitality it is necessary an annessiectomy. We reported a case of bilateral asynchronous adnexal torsion in a women of 30 years old: a right ovarectmoy for ovarian torsion in 2008 and the second one in 2012. Even if bilateral asynchronous ovarian torsion is a very rare gynecological disease it is important to suspect it, also when there are no specific symptoms. A conservative de-torsion is not always successful and so the patient must always well informed about the possible implications and complications of her disease.

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