A Case of Twisted Ovaries

Ovarian torsion isn’t a term people hear very often, but it recently hit the headlines when actress Busy Philipps from the TV show Vice Principals was sent to the hospital in excruciating abdominal pain. The diagnosis: a twisted ovary, or ovarian torsion.

Jefferson/Nemours pediatric and adolescent gynecologist Beth Schwartz, M.D. spoke with Health.com about the condition.

“What this means is that the ovary or the fallopian tube—or both—twists around itself,” Dr. Schwartz told Health.com. “Think about any part of your body twisting, and you can see how that could really hurt.”

Ovarian torsion is rare, with less than 3 percent of women experiencing the condition and the only definitive way to diagnose and repair torsion is via surgery. If not treated quickly, the blood vessels can become twisted shut, stunting blood flow and oxygen to the ovary, which can affect the woman’s fertility later in life. It’s unclear what causes ovarian torsion, said Dr. Schwartz, but it is more common in younger women at an average age 28 years old.

Dr. Schwartz, an assistant professor in Obstetrics and Gynecology at Thomas Jefferson University and Nemours/Alfred I. duPont Hospital for Children, recently developed a score to help physicians diagnose the condition in young girls: children and adolescents. To come up with this diagnostic tool, Dr. Schwartz and her colleagues studied 324 girls between the ages of 6 and 21 who experienced abdominal pain and assessed the symptoms that were associated with the diagnosis of ovarian torsion. They found that although pain is often associated with ovarian torsion, pain alone wasn’t a good predictor of the diagnosis. Instead, vomiting, and the size of ovarian or tubal cyst were better predictors. If used proactively, the tool could prevent unnecessary surgery. The study was published in the Journal of Pediatric and Adolescent Gynecology.

“We are already beginning to use this tool at Jefferson to help determine when a patient has a high likelihood of having this serious condition, and when the abdominal pain is likely to be caused by something else, and we can defer surgery” says Dr. Schwartz.

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