Adnexal torsion is one of the most common gynecologic surgical emergencies. All age groups can be affected, but torsion of normal-sized ovary that happens during late pregnancy is rare and challenging to be diagnosed. The objective of this article is to present a case of adnexal torsion in a normal-sized ovary suspected by magnetic resonance imaging (MRI) in the third trimester of pregnancy. A 36-year-old woman at 32 + 5 weeks gestational age was admitted to hospital due to recurrent severe left lower abdominal pain. Doppler ultrasound failed to demonstrate the ovarian diseases, while MRI scan suspected the diagnosis of adnexal torsion. The patient received emergent exploratory laparotomy, and the left adnexa with a necrotic ovary was removed. Tocolytic therapy was used before and after surgery. Finally, she delivered a healthy full-term infant via cesarean section. Adnexal torsion occurring in a normal-sized ovary was quite rare in the third trimester pregnancy. MRI might be better than ultrasound in the early diagnosis of ovarian torsion.
Keywords: adnexal torsion; magnetic resonance imaging; pregnancy; surgery.
© 2018 Japan Society of Obstetrics and Gynecology.