Torsion of a Normal Ovary During the Early Postpartum Period

Yusuke Tanaka, MD, Shinsuke Koyama, MD, PhD, Yasuhiko Shiki, MD

Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan (all authors).

ABSTRACT

Ovarian cyst torsion is a well-known cause of acute abdominal pain in female patients. However, torsion of a normal ovary is extremely rare and predominantly occurs in premenarchal female patients. The objective of this report is to describe a rare case of acute abdomen during the early postpartum period that was ultimately diagnosed as torsion of a normal ovary by laparoscopic surgery. A 29-year-old woman vaginally delivered a healthy 3530-g baby uneventfully at 40 weeks’ gestation. On postpartum day 6, she presented with acute abdominal pain in the right lower quadrant and costovertebral angle tenderness. A complete workup including laboratory examination, ultrasonography, and computed tomography was performed. Leukocytosis with a left shift and a slightly enlarged right ovary were found. Finally, diagnostic laparoscopy showed torsion of a normal ovary. The patient underwent laparoscopic detorsion of the right adnexa and was discharged on postoperative day 4 without any complications.

Key Words: Adnexal torsion, Acute abdomen, Laparoscopy, Postpartum, Pregnancy.

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