Shyy William, Knight Roneesha S, Teismann Nathan A
Department of Emergency Medicine, San Francisco General Hospital, San Francisco, California; Department of Emergency Medicine, University of California, San Francisco, San Francisco, California.
Department of Emergency Medicine, San Francisco General Hospital, San Francisco, California.
J Emerg Med. 2018 Aug;55(2):e43-e45. doi: 10.1016/j.jemermed.2018.01.006. Epub 2018 Feb 17.
Abdominal pain is one of the most common chief complaints of patients presenting to emergency departments, and emergency physicians (EPs) often evaluate patients with right lower quadrant abdominal pain. Ovarian torsion is a rare cause of abdominal pain, but early diagnosis is essential for salvage of the affected ovary. The diagnostic study of choice for ovarian torsion is a pelvic ultrasound with color Doppler, but it is important for EPs and radiologists to be aware of findings of ovarian torsion that might appear on computed tomography (CT).
We present a case of a young female with right lower quadrant abdominal pain with CT evidence of ovarian torsion that was not recognized; the patient was discharged and then called back when the study was over-read as concerning for ovarian torsion. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The presence of radiographic findings associated with ovarian torsion on a CT scan should encourage an EP to order a pelvic ultrasound with color Doppler (if available) and obtain an obstetrics/gynecology consult.
腹痛是前往急诊科就诊患者最常见的主要症状之一，急诊医师（EPs）经常评估右下腹痛的患者。卵巢扭转是腹痛的罕见原因，但早期诊断对于挽救受影响的卵巢至关重要。卵巢扭转的首选诊断研究是经阴道彩色多普勒超声检查，但急诊医师和放射科医生了解计算机断层扫描（CT）上可能出现的卵巢扭转表现很重要。
我们报告一例年轻女性右下腹痛病例，CT显示有卵巢扭转迹象但未被识别；患者出院，研究结果被重新解读为疑似卵巢扭转后被召回。急诊医师为何应了解这一点？：CT扫描上出现与卵巢扭转相关的影像学表现应促使急诊医师开具经阴道彩色多普勒超声检查（如有）并咨询妇产科医生。
