Aim and objective: Adnexal torsion is a rare gynecological emergency involving females of all age-groups. It requires early diagnosis and intervention in order to save the adnexa from irreversible injury. Our study elaborates on the clinical presentation, diagnosis, and management of adnexal torsion in a tertiary care centre in India.

Study design: Prospective study.

Materials and methods: It is a clinical study conducted at Sri Ramachandra Institute of Research and Higher Education over a period of 1 year from January 2018 to January 2019.

Results: Most cases of adnexal torsion presented with diffuse pain abdomen (64.2%), nausea and vomiting (42.8%). About 60% were mainly found in the reproductive age-group of 20–30 years. Five antenatal cases with adnexal torsion were observed (11%) in the study period. Polycystic ovaries (21.4%) and hypothyroidism (50%) were the notable associated risk factors. Cyst size of more than 5 cm was increasingly associated with torsion. Ultrasound was used as a primary imaging modality. Few cases involving pregnant women and larger masses in which ultrasound was inconclusive , CT and MRI were more convincing. Laparoscopy was the preferred mode of intervention with an attempt to conserve the ovary in childbearing age-group. However, 24% of cases were converted to laparotomy in view of large size of the mass or hemodynamic instability.

Conclusion: Adnexal torsion is one of the rare emergencies which requires an expertise team for early diagnosis using imaging and clinical symptoms. Prompt surgical intervention is required to preserve the ovarian tissue especially in younger age-group.

Dr. Sneha Mathimaaran has completed her masters in Obstetrics and Gynaecology with Gold medal from the reputed Sri Ramachandra Medical University in Chennai, India. She received the Dr. Savitri award for the Best Outgoing Doctor of her batch. She has completed her fellowship in minimal access surgery. Her interests involve high risk obstetrics, gynaecological endoscopy and robotics. She has presented papers and posters in regional and national conferences in India and has publications in national and international journals.