Ovarian Torsion in The Third Trimester of A Twin Pregnancy: A Case Report

Year 2023, Volume: 2 Issue: 1, 22 - 25, 30.03.2023

Deniz Kulaksız , Kübra Baki Erin , Recep Erin , Yeşim Bayoğlu Tekin , Ecenur Arslan Reis

Abstract

During pregnancy, ovarian torsion (OT) occurs at a rate of 1 to 5 per 100,000 and is extremely uncommon. There is only one case report of OT occurring in a third-trimester, twin pregnancy. In the present case, a 30-year-old female patient whose first pregnancy was dichorionic diamniotic and at 30 weeks of age was admitted to our emergency service with the complaint of chronic pain. The patient had a history of spontaneous pregnancy and an increase in carcinoembryonic antigen level was found in her biochemical indicators. Magnetic resonance imaging and Doppler ultrasound indicated OT, therefore she had surgery that involved making a midline incision under the umbilicus. Both ovary and tuba uteri were removed as they were necrotic and twist on the right side of the adnexa. No complications developed following the surgery and pathology showed mucinous cyst adenoma. The most common causes of abdominal pain in the third trimester are gas, constipation, Braxton-Hicks, urinary tract infection, appendicitis, and preeclampsia. Although OT is extremely rare in the third trimester of spontaneous twin pregnancies, it should be considered in the differential diagnosis.

Keywords

Torsion, Twin pregnancy, Third trimester

İkiz Gebeliğin Üçüncü Trimesterinde Over Torsiyonu: Olgu sunumu

Abstract

Hamilelik sırasında over torsiyonu (OT) 100.000'de 1 ila 5 oranında meydana gelir ve oldukça nadirdir. Üçüncü üç aylık dönemde, ikiz gebelikte meydana gelen OT ile ilgili yalnızca bir vaka raporu vardır. Bizim olgumuzda 30 yaşında, ilk gebeliği olan dikoryonik diamniyotik 30 haftalık kadın hasta, kronik ağrı şikayeti ile acil servisimize başvurdu. Spontan gebelik öyküsü olan hastanın
biyokimyasal göstergelerinde karsinoembriyonik antijen düzeylerinde yükseklik saptandı. Manyetik rezonans görüntüleme ve Doppler ultrason OT lehineydi, bu nedenle göbek altında orta hat insizyonu ile ameliyat edildi. Hem yumurtalık hem de tuba uteri, nekrotik olduklarından ve adneksin sağ tarafında büküldüklerinden dolayı çıkarıldı. Ameliyat sonrası herhangi bir komplikasyon gelişmedi ve patoloji müsinöz kist adenomu olarak geldi. Üçüncü trimesterde karın ağrısının en yaygın nedenleri gaz, kabızlık, Braxton-Hicks, idrar yolu enfeksiyonu, apandisit ve preeklampsidir. Spontan ikiz gebeliklerin üçüncü trimesterinde OT oldukça nadir olmakla birlikte ayırıcı tanıda gözönünde bulundurulmalıdır.

Keywords

İkiz gebelik, Torsiyon, Üçüncü trimester

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