An update on the diagnosis and management of ovarian torsion

<jats:sec><jats:title>Key content</jats:title><jats:p> <jats:list list-type="bullet"> <jats:list-item><jats:p>Torsion of the ovary, tube or both is estimated to be responsible for only a small number of all gynaecological emergencies, but is a common diagnostic challenge in the emergency setting.</jats:p></jats:list-item> <jats:list-item><jats:p>Diagnosis can be difficult and is mainly based on clinical symptoms and imaging techniques such as ultrasound and MRI.</jats:p></jats:list-item> <jats:list-item><jats:p>A normal ultrasound scan does not exclude adnexal torsion and the decision to operate should be made on clinical grounds if symptoms are severe.</jats:p></jats:list-item> <jats:list-item><jats:p>Treatment is traditionally surgical removal of the ovary or adnexum, however, there is increasing evidence for conservative surgery, such as de‐torsion and oophoropexy, particularly in younger women.</jats:p></jats:list-item> <jats:list-item><jats:p>This article provides an overview of the symptomatology, ultrasound diagnosis and classification, as well as treatment options for ovarian torsion.</jats:p></jats:list-item> </jats:list> </jats:p></jats:sec><jats:sec><jats:title>Learning objectives</jats:title><jats:p> <jats:list list-type="bullet"> <jats:list-item><jats:p>To understand the clinical presentation and ultrasound characteristics associated with ovarian torsion.</jats:p></jats:list-item> <jats:list-item><jats:p>To review the literature on the available surgical options.</jats:p></jats:list-item> </jats:list> </jats:p></jats:sec><jats:sec><jats:title>Ethical issues</jats:title><jats:p> <jats:list list-type="bullet"> <jats:list-item><jats:p>Oophorectomy is commonly performed for adnexal torsion with a possible negative impact on fertility in women of reproductive age. De‐torsion is a more conservative surgical approach that should be considered in all younger women with ovarian torsion.</jats:p></jats:list-item> </jats:list> </jats:p></jats:sec>