Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion

Case Presentation: A 28-year-old female presented to the emergency department complaining of right lower abdominal pain. A contrast-enhanced computed tomography (CT) was done, which showed a 15-centimeter right adnexal cyst with adjacent “whirlpool sign” concerning for right ovarian torsion. Transva...

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Autores principales:	Joshua K. Livingston, Savannah Gonzales, Mark I. Langdorf
Formato:	article
Lenguaje:	EN
Publicado:	eScholarship Publishing, University of California 2021
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/0aa59a3a10a0454f81bb7d95954f0eef
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spelling	oai:doaj.org-article:0aa59a3a10a0454f81bb7d95954f0eef2021-11-23T20:02:52ZComputed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion2474-252X10.5811/cpcem.2021.7.53317https://doaj.org/article/0aa59a3a10a0454f81bb7d95954f0eef2021-11-01T00:00:00Zhttps://escholarship.org/uc/item/9n225801https://doaj.org/toc/2474-252XCase Presentation: A 28-year-old female presented to the emergency department complaining of right lower abdominal pain. A contrast-enhanced computed tomography (CT) was done, which showed a 15-centimeter right adnexal cyst with adjacent “whirlpool sign” concerning for right ovarian torsion. Transvaginal pelvic ultrasound (US) revealed a hemorrhagic cyst in the right adnexa, with duplex Doppler identifying arterial and venous flow in both ovaries. Laparoscopic surgery confirmed right ovarian torsion with an attached cystic mass, and a right salpingo-oophorectomy was performed given the mass was suspicious for malignancy. Discussion: Ultrasound is the test of choice for diagnosis of torsion due to its ability to evaluate anatomy and perfusion. When ovarian pathology is on the patient’s right, appendicitis is high in the differential diagnosis, and CT may be obtained first. Here we describe a case where CT first accurately diagnosed ovarian torsion by demonstrating the whirlpool sign, despite an US that showed arterial flow to the ovary. Future studies should determine whether CT alone is sufficient to diagnose or exclude ovarian torsion.Joshua K. LivingstonSavannah GonzalesMark I. LangdorfeScholarship Publishing, University of CaliforniaarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENClinical Practice and Cases in Emergency Medicine, Vol 5, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Joshua K. Livingston Savannah Gonzales Mark I. Langdorf Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion
description	Case Presentation: A 28-year-old female presented to the emergency department complaining of right lower abdominal pain. A contrast-enhanced computed tomography (CT) was done, which showed a 15-centimeter right adnexal cyst with adjacent “whirlpool sign” concerning for right ovarian torsion. Transvaginal pelvic ultrasound (US) revealed a hemorrhagic cyst in the right adnexa, with duplex Doppler identifying arterial and venous flow in both ovaries. Laparoscopic surgery confirmed right ovarian torsion with an attached cystic mass, and a right salpingo-oophorectomy was performed given the mass was suspicious for malignancy. Discussion: Ultrasound is the test of choice for diagnosis of torsion due to its ability to evaluate anatomy and perfusion. When ovarian pathology is on the patient’s right, appendicitis is high in the differential diagnosis, and CT may be obtained first. Here we describe a case where CT first accurately diagnosed ovarian torsion by demonstrating the whirlpool sign, despite an US that showed arterial flow to the ovary. Future studies should determine whether CT alone is sufficient to diagnose or exclude ovarian torsion.
format	article
author	Joshua K. Livingston Savannah Gonzales Mark I. Langdorf
author_facet	Joshua K. Livingston Savannah Gonzales Mark I. Langdorf
author_sort	Joshua K. Livingston
title	Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion
title_short	Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion
title_full	Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion
title_fullStr	Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion
title_full_unstemmed	Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion
title_sort	computed tomography appearance of the “whirlpool sign” in ovarian torsion
publisher	eScholarship Publishing, University of California
publishDate	2021
url	https://doaj.org/article/0aa59a3a10a0454f81bb7d95954f0eef
work_keys_str_mv	AT joshuaklivingston computedtomographyappearanceofthewhirlpoolsigninovariantorsion AT savannahgonzales computedtomographyappearanceofthewhirlpoolsigninovariantorsion AT markilangdorf computedtomographyappearanceofthewhirlpoolsigninovariantorsion
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Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion

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