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RADQUIZ -APRILE - OVARIAN CYST TORSION

Autori: Luigia Loi , Paolo Siotto, Danilo Sirigu

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Patient ,29 years old, affected by velocardiofacial Syndrome (22q11.2 deletion Syndrome), non-cooperative, with strong abdominal pain localized to the lower quadrants.

ULTRASONOGRAPHIC EVALUATION:
Non-cooperative patient: in the true pelvis and in the right iliac fossa a gross formation of about 18 cm is present. The formation is inhomogeneously echogenic and it shows avascular at Color Doppler .
The lesion is responsible for posterior compression of the bladder and the uterus.
A very small abdominal effusion is concomitant.

CT EVALUATION (assial , coronal and sagittal scans)
Gross hypodense formation in the right adnexa. The lesion is ovoid, it shows non evidence of wall and it’s avascular.
A slight peritoneal effusion is associated.
The left adnexa and the uterus appear normal.

DIAGNOSIS

Ovarian cyst torsion confirmed by surgery.

DISCUSSION:

Torsion can be a dangerous complication of an ovarian cyst.

In acute forms, first venous stasis, then intracystic hemorrhage, finally ischemia occur, with potential suppuration and/or rupture.

The clinical pattern can evolve into death of the patient due to shock or peritonitis

References:

H. C. Chang, S. Bhatt, and V. S. Dogra
Pearls and Pitfalls in Diagnosis of Ovarian Torsion
RadioGraphics, September 1, 2008; 28(5): 1355 - 1368.

S.-Y. Chiou, A. S. Lev-Toaff, E. Masuda, R. I. Feld, and D. Bergin
Adnexal Torsion: New Clinical and Imaging Observations by Sonography, Computed Tomography, and Magnetic Resonance Imaging
J. Ultrasound Med., October 1, 2007; 26(10): 1289 – 1301

N. Hiller, L. Appelbaum, N. Simanovsky, A. Lev-Sagi, D. Aharoni, and T. Sella
CT Features of Adnexal Torsion
Am. J. Roentgenol., July 1, 2007; 189(1): 124 – 129

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