Has Ultrasound the sensitivity and specificity to make an accurate diagnosis of Adnexal Torsion?
Sarah Kordula, Nottingham University Hospitals NHS Trust in conjunction with University of Derby
Background
Adnexal Torsion (AT) is defined as the twisting by at least one complete turn of the tube and ovary, or more rarely the fallopian tube alone around the infundibulopelvic and utero-ovarian ligaments. AT can affect normal ovaries. The ovarian vessels become compressed. Venous and lymphatic flow affected first, leading to ovarian oedema. Muscular arteries resist occlusion more than veins – however spectral doppler may appear abnormal as torsion increases. Total obstruction is a late sign, due to dual ovarian arterial flow. AT can occur at any age, mean occurrence in the reproductive years. Untreated, ovarian ischaemia and necrosis occurs. Fertility can be affected, clinical health compromised by haemorrhage, infection and peritonitis.