Abstract: Massive ovarian oedema is a rare, poorly understood condition with highly varied clinical presentation. Partial torsion of the vascular pedicle compromising veno-lymphatic drainage without affecting arterial supply has been hypothesized to be the aetiology. Thus far only about 200 cases have been documented in literature, the first one being in 1969. These patients may present with acute abdomen, menstrual irregularities, abdominal masses, abdominal distension or virilization. Despite generally being benign in nature, and lacking any hallmark radiological signs, imaging frequently raises the suspicion of malignancy. In up to 85% cases there is no primary ovarian pathology. Yet, a large majority of cases undergo extensive, often unnecessary extirpative surgery, negatively affecting hormonal function with implications on future reproductive potential. A review of literature suggests that judicious use of ovarian wedge resection with symptomatic management is likely to yield better outcomes.
We present a case of a 19-year-old girl with acute abdomen with imaging suggestive of bilateral ovarian torsion and the sequence of events that unfurled. Our case further emphasizes the lacunae in our understanding of this elusive condition and the need for more research to establish robust, evidence-based management protocols.
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