Ovarian torsion and the ultrasound whirlpool sign

On Doppler ultrasound, the whirlpool sign describes vessels and supporting tissue spiralling around the point of twisting. This pattern can support ovarian torsion because the ovary, tube and their blood supply may rotate together. The ovary may also look enlarged or sit in an unusual position, although findings vary.

Ultrasound is useful but not a stand-alone answer. Blood flow may still be visible, particularly if the twist is incomplete or intermittent. A clinician weighs the scan alongside one-sided pelvic pain, nausea, vomiting and examination findings.

A possible whirlpool sign should be discussed promptly with the treating team. If torsion is strongly suspected, a gynaecologist may recommend urgent laparoscopy to untwist the ovary and inspect the tissue. [Laparoscopic Ovarian Cystectomy](/treatments/gynaecological-surgery/laparoscopic-ovarian-cystectomy/) describes a related keyhole operation used when a cyst also needs removal.

Bring details about when the pain began, whether it comes in waves, and any vomiting or faintness. Those details help the team interpret an imaging finding in context.

Go to emergency care for sudden or severe pelvic pain, repeated vomiting, fever, faintness or a tender abdomen, whether or not an ultrasound has already been performed. Do not wait for a routine appointment if symptoms are escalating.

Ask what the radiologist saw, whether the ovary appears enlarged or poorly positioned, and how the scan changes the treatment plan. Ask what other diagnoses are being considered if the scan is uncertain.