Ovarian torsion clinical presentation: what should you know?

Torsion happens when an ovary twists around its supporting tissues. Pain may be sharp, persistent, or intermittent, and it may spread into the lower abdomen, back, or thigh. Nausea and vomiting can occur because the pain is intense. Some people have tenderness, bloating, or a low fever, while others have a less obvious pattern. The clinical presentation can overlap with appendicitis, a ruptured cyst, ectopic pregnancy, or other causes of [Pelvic Pain](/symptoms/pelvic-pain/), so symptoms alone cannot establish the diagnosis.

Write down when the pain started, whether it is on one side, whether it comes in attacks, and any vomiting, bleeding, fever, or urinary symptoms. Tell the clinician about known cysts, fertility treatment, pregnancy possibility, and previous operations. Assessment commonly involves an examination and ultrasound with blood-flow assessment, but findings can be unclear. If torsion remains a concern, a gynaecology team may recommend urgent surgery to inspect and untwist the ovary. [Laparoscopic Ovarian Cystectomy](/treatments/gynaecological-surgery/laparoscopic-ovarian-cystectomy/) is a related procedure when a cyst needs removal.

Go to an emergency department for sudden severe pelvic or lower abdominal pain, pain with vomiting, faintness, fever, or increasing abdominal tenderness. Get urgent help even if the pain temporarily improves, because intermittent twisting can produce symptoms that fluctuate. If pregnancy is possible, say so immediately because pregnancy-related emergencies can resemble torsion.

Which other conditions can resemble this presentation? What did the ultrasound show about the ovary and its blood flow? How will you decide whether I need urgent laparoscopy? What symptoms should I watch for after going home?