Acute ovarian torsion: symptoms and urgent care

It often presents with sudden, strong pain on one side of the lower abdomen or pelvis. Nausea and vomiting may accompany the pain, which can be constant or come and go if the ovary twists and partly untwists.

An enlarged ovary can be more mobile, so an ovarian cyst or mass may increase the chance of twisting. Torsion can also occur without a known cyst, including during pregnancy or after fertility treatment when ovaries may be enlarged.

Symptoms overlap with appendicitis, a ruptured cyst, ectopic pregnancy, kidney stones and other urgent conditions. A pregnancy test, examination, blood tests and pelvic ultrasound can help the clinical team, but no single finding always settles the diagnosis.

Go to an emergency department now for sudden severe pelvic or lower-abdominal pain, particularly when it is one-sided or occurs with vomiting. Do not wait for a routine appointment or try to confirm the cause at home. Avoid eating or drinking until the emergency team advises you, because an operation may be considered.

Treatment commonly involves urgent laparoscopy to untwist the ovary and assess its blood supply. If a cyst contributed, the surgeon may address it while preserving healthy ovarian tissue where feasible. The exact procedure depends on what is found during surgery.

Call emergency services if severe pelvic pain is accompanied by fainting, collapse, confusion, breathing difficulty, heavy vaginal bleeding or signs of shock such as pale, clammy skin. Arrange immediate transport to hospital if pain returns after temporarily easing; intermittent relief does not rule torsion out.

Tell the emergency team about a possible pregnancy, fertility medicines, known ovarian cysts, previous torsion and any pelvic surgery. These details help guide testing without delaying care.

Useful questions include what other causes are being considered, whether imaging shows an enlarged ovary or cyst, whether laparoscopy is recommended, and how the proposed procedure could affect the ovary. After treatment, ask which pain, fever, wound change or vomiting should bring you back to hospital.