Acute Abdomen in Pregnancy Due to Ovarian Torsion: A Case Report

ACUTE ABDOMEN IN PREGNANCY

Abstract

Introduction: Acute abdomen from ovarian torsion is a rare complication of pregnancy. This case report highlights the place of ovarian torsion as a cause of acute abdomen in pregnancy, management challenges, importance of early diagnosis and the need for prompt intervention.

Case presentation: A 30-year-old primiparous woman at 18 weeks of gestation presented with complaints of abdominal pain and vomiting. She was in distress with generalized abdominal tenderness and guarding. Abdominal ultrasound showed a cystic mass in the right hypochondrion. A diagnosis of acute abdomen in pregnancy was made and she had an emergency laparotomy and right salpingo-oophorectomy with findings of a twisted haemorrhagic right ovarian mass. Histology of the ovarian mass showed a matured (benign) cystic teratoma.

Conclusion: Acute abdomen in pregnancy is an obstetric emergency. Diagnosis is often unclear due to a long list of differentials. Uterine size, changes in maternal physiology and fetal considerations may pose further management challenges. Ovarian torsion should be considered early and timely surgical intervention provided for optimal maternal and fetal outcomes.