Torsión Ovárica
Femenina , 31 años edad, menarquia a los 13 años, primera relacion sexual a los 16 años. Gesta 3 Cesáreas 3. Usando anticoncepción con Norplan (R) hasta hace 2 meses,desde entonces usa eyaculacion fuera como método de anticoncepcion. Desde hace 2 semanas presenta fuertes dolores pelvicos que ha pesar de los analgésicos administrados ha ido en aumento. Amenorrea compatible con posibilidad de embarazo de 5,0 semanas. La paciente llega a la consulta casi arrastrándose del intenso dolor. El examen sonografico transvaginal muestra útero no gestante con línea endometrial sin reacción decidual de aprox: 12,5 mm de grosor. Ovario derecho sonograficamente normal. El ovario izquierdo luce aumentado de tamaño, con aspecto edematoso, rodeado de líquido el cual se aprecia también en fondo de saco posterior, El ovario izquierdo mide aprox: 5,22 X 4,70 X 3,73 cm, volumen aprox: 47,92 c.c. Se concluye con el diagnostico de torsión ovario izquierdo.La paciente fue intervenida y el diagnostico intra-operatorio fue quiste hemorragico junto a gran cantidad de sangre liquida en cavidad. El probable motivo de confusión fue la interpretación del flujo vascular que dio la impresión de estar suficientemente disminuido para junto al edema ovárico, sustentar el diagnostico de torsión ovárica.
Female, 31 years old, menarche at 13 years, first sexual relation at 16 years. Gesta 3 Cesarean 3. Using contraception with Norplant (R) until 2 months ago, since then it uses ejaculation out as a method of contraception. For the past 2 weeks, it has had severe pelvic pains that have taken up administered analgesics has been increasing. Amenorrhea was compatible with 5.0 weeks of pregnancy possibility. The patient arrives at the office almost crawling from the intense pain. The transvaginal sonographic examination shows a non-pregnant uterus with an endometrial line with no decidual reaction of approximately 12.5 mm thickness. Ovary sonographically normal right. The left ovary appears enlarged, with an edematous aspect, surrounded by fluid, which is also seen in the posterior sac. The left ovary measures approx: 5.22 X 4.70 X 3.73 cm, volume approx: 47, 92 cc It was concluded with the diagnosis of left ovary torsion. The patient was operated on and the intraoperative diagnosis was a hemorrhagic cyst with a large amount of blood in the cavity. The probable cause of confusion was the interpretation of the vascular flow that gave the impression of being sufficiently diminished in addition to the ovarian edema, to support the diagnosis of ovarian torsion.
Ovarian Torsion
Female, 31 years old, menarche at 13 years, first sexual relation at 16 years. Gesta 3 Cesarean 3. Using contraception with Norplant (R) until 2 months ago, since then it uses ejaculation out as a method of contraception. For the past 2 weeks, it has had severe pelvic pains that have taken up administered analgesics has been increasing. Amenorrhea was compatible with 5.0 weeks of pregnancy possibility. The patient arrives at the office almost crawling from the intense pain. The transvaginal sonographic examination shows a non-pregnant uterus with an endometrial line with no decidual reaction of approximately 12.5 mm thickness. Ovary sonographically normal right. The left ovary appears enlarged, with an edematous aspect, surrounded by fluid, which is also seen in the posterior sac. The left ovary measures approx: 5.22 X 4.70 X 3.73 cm, volume approx: 47, 92 cc It was concluded with the diagnosis of left ovary torsion. The patient was operated on and the intraoperative diagnosis was a hemorrhagic cyst with a large amount of blood in the cavity. The probable cause of confusion was the interpretation of the vascular flow that gave the impression of being sufficiently diminished in addition to the ovarian edema, to support the diagnosis of ovarian torsion.
