Bilateral torsion of the adnexa: a case report and a review of the world literature.

The 15th case of bilateral adnexal torsion, or the fifth case in which the bilateral adnexal torsion did not occur simultaneously, is presented. A review of the cases reported in the world literature reveals that fever (82%), nausea and/or vomiting (73%), and abdominal pain (93%) were the most common symptoms. Previous recurrent attacks of abdominal pain occurred in 53% of patients and may be the one finding that is highly suggestive of this entity. The adnexa were histologically normal in 50% of the specimens, with the remaining adnexal tissues manifesting evidence of tubal infection (ie, hydrosalpinx and pyosalpinx). The diagnosis was suspected preoperatively in only 38% of the cases.