The patient was admitted to the hospital in a state of subdued abdominal pain, no fever, no nausea. Although the symptoms were not typical and not too loud, the history of having left ovarian torsion and having undergone surgery in 2025 made doctors particularly concerned.
Through clinical examination combined with ultrasound, doctors discovered two large ovaries with many small cysts suggesting images of polycystic ovaries. Among them, the left ovary is significantly larger, the stromal tissue is edgy, and especially the "whirlpool sign" appears - a specific spiral stem sign on ultrasound, which strongly suggests ovarian torsion diagnosis.
It is noteworthy that on Doppler ultrasound, the ovaries still have pulse signals. This is a factor that can make the diagnosis easily missed if only based on blood flow to rule out ovarian torsion. However, with clinical experience, caution and in-depth expertise in diagnostic imaging, doctors determined that this was a case of recurrent ovarian torsion and decided to indicate surgery early.
The surgical result was completely consistent with the preoperative diagnosis, helping the patient to be treated promptly, avoiding the risk of ovarian necrosis and preserving fertility.
According to Dr. Nguyen Thai Giang, Deputy Head of the Department of Obstetrics and Oncology, this is a case of recurrent ovarian torsion in young patients, without ovarian tumors, so the risk of continued recurrence in the future is very high. Therefore, after removing the torsion, the surgical team performed additional technique of sewing the ovary into the ovarian fossa to reduce the risk of recurrence of torsion.
This is a rare and difficult technique, because the ovaries are located near many important structures such as blood vessels and ureters. If operating carelessly, patients may face the risk of damage to nearby organs. However, in this case, fitting the ovaries is considered necessary, proactive to preserve long-term reproductive function for young patients.
Doctors said that the case was detected early thanks to caution in clinical examination, combined with ultrasound to detect the characteristic "whirlpool sign", although Doppler still had flow. This once again shows that ovarian torsion cannot be ruled out based only on Doppler ultrasound. The rapid coordination between clinicians, diagnostic imaging doctors and the surgical team helped the patient to be treated in "golden hours", avoiding severe complications and keeping the opportunity to become a mother in the future.
Although there were no severe symptoms, the case still posed many challenges in diagnosis and treatment.
