Endovaginal Doppler ultrasound in ovarian torsion: a case series.

Four women with acute pelvic pain clinically suspected to be secondary to ovarian torsion were examined with gray-scale and Doppler ultrasound. All affected ovaries were enlarged (volumes 3.2-34 times the volumes of the ovaries on the unaffected sides). Three ovaries showed no internal flow, and one showed internal arterial flow. Ovary-conserving treatment was attempted in all four cases but the three ovaries which showed no evidence of internal flow eventually required removal. The fourth case, in which arterial flow was present on Doppler examination, was treated only with laparoscopic untwisting of the pedicle and did not require oophorectomy. The results of our study suggest that Doppler findings may distinguish ovaries which are beyond salvage and require removal from those which may be saved by prompt laparoscopic untwisting of the adnexa, but further studies with larger numbers of patients will be necessary.