A rare surgical emergency during pregnancy: a case report

TL;DR

This case report describes a rare surgical emergency in a pregnant woman involving a twisted ovary, which was initially mistaken for appendicitis.

Contribution

The novelty lies in highlighting adnexal torsion in the third trimester of pregnancy as a rare but critical condition requiring prompt diagnosis.

Findings

Adnexal torsion was diagnosed in a 30-week pregnant patient initially suspected of having appendicitis.

Surgical exploration revealed a necrotic ovary and reactive appendicitis, leading to oophorectomy and appendectomy.

The patient had an uneventful postoperative recovery, emphasizing the importance of early intervention.

Abstract

Acute pelvic pain during pregnancy often presents a diagnostic challenge. We report a case of adnexal torsion occurring in the third trimester of pregnancy in order to highlight this diagnosis, for which only early management can prevent irreversible ischemic damage that may compromise future fertility. The patient was a nulliparous woman at 30 weeks of amenorrhea who initially presented with symptoms suggestive of appendicitis. Through a McBurney incision, surgical exploration revealed a necrotic right ovary associated with reactive appendicitis. An oophorectomy and appendectomy were performed. The postoperative course was uneventful.

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