Adnexal Torsion

This condition occurs when the adnexa (the fallopian tubes and ovaries) twists. Patients need surgery to fix it.

What Is Adnexal Torsion?

Adnexa is a term to describe the fallopian tubes and ovaries. Torsion (tor-shn) is when the adnexa twist inside the pelvis. Torsion can block some of the blood from flowing to and from the adnexa. This could lead to tissue death (necrosis) and damage.

What Causes Adnexal Torsion?

  • Adnexal torsion may involve the fallopian tubes, ovaries or both. There is no one reason adnexal torsion happens.
  • A mass can increase the risk of torsion. Normal adnexa without a mass can twist (torse).
  • Looser ligaments that connect the adnexa to the pelvic wall and uterus can cause adnexal torsion.
  • A small size of a uterus compared to the adnexa.

What Are the Signs and Symptoms of Adnexal Torsion?

With adnexal torsion, you will have sudden pelvic pain. You may also have nausea or vomiting (throwing up).

How Is Adnexal Torsion Diagnosed?

  • Adnexal torsion cannot be confirmed or ruled out with a blood test or imaging tests. The only way to know if a patient has adnexal torsion is to do a laparoscopy.
    • Laparoscopy is a procedure where a surgeon can get inside the belly (abdomen) without making a large cut (incision) in the skin.
  • If a patient is suspected of having an adnexal torsion, they must have an emergency diagnostic laparoscopy.

How Is Adnexal Torsion Treated?

  • To treat adnexal torsion, the patient needs emergency surgery to untwist (detorse) the adnexa. This will keep blood flowing and prevent life-long damage.
  • This surgery can usually be done laparoscopically by not removing the adnexa. If there is a mass on the adnexa, it may be removed at the time of the emergency surgery.
  • Sometimes, a second procedure is needed to go back and remove the adnexal mass after the swelling a from the torsion goes down.