Acute abdomen caused by adnexal torsion in the first trimester of pregnancy: a case report

• Published in: Srpski arhiv za celokupno lekarstvo Vol. 139; no. 3-4; pp. 239 - 241
• Main Authors: Terzić, Milan, Aksam, Slavica, Maricić, Sanja, Arsenović, Nebojsa
• Format: Journal Article
• Language: English
• Published: Serbia Serbian Medical Society 01.03.2011
• Subjects: Abdomen, Acute - etiology; Adnexal Diseases - complications; Adnexal Diseases - diagnosis; adnexal torsion; Adult; Female; first trimester; Humans; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Trimester, First; surgery; Torsion Abnormality - complications; Torsion Abnormality - diagnosis; ultrasound
• ISSN: 0370-8179; 2406-0895
• DOI: 10.2298/SARH1104239T

Adnexal torsion is a rare cause of acute abdominal pain during pregnancy. The clinical and laboratory findings are non-specific. In this paper we present a case of adnexal torsion in the first trimester of pregnancy. On admission, the patient presented signs of acute abdomen.The pain started few hours prior to admission, and was predominantly localized, occasionally irradiating to the central parts of the lower abdomen, accompanied by nausea and vomiting. Ultrasound revealed viable intrauterine pregnancy and right adnexal mass with small amount of free fluid in the Douglas pouch. After short preoperative evaluation, laparotomy and adnexectomy were performed. Surgery and postoperative followup were uneventful, and histopathology reported torquated corpus luteum cysts. The diagnosis of adnexal torsion during pregnancy is difficult, and occasionally remains a diagnostic dilemma. Surgery is inevitable, must be prompt, and comprises adnexectomy.