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Ovarian Torsion

Metabolism and Endocrine Disease · NLM MeSH · updated 2026-11-04 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 4 min read

A condition that occurs when an ovary twists around the ligaments that hold it in place.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (717 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

A condition that occurs when an ovary twists around the ligaments that hold it in place. This twisting can cut off blood flow. It usually affects only one ovary.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Ovarian Torsions; Torsion, Ovarian; Torsions, Ovarian; Adnexal Torsion; Adnexal Torsions; Torsion, Adnexal; Torsions, Adnexal.

Where it fits in the MeSH classification

Broader topics
Ovarian Diseases; Torsion Abnormality

Research landscape

PubMed indexes 309 records tagged with the MeSH heading “Ovarian Torsion” (counts retrieved 2026-11-04). 308 of them (99.7%) were published from 2020 onward, and the busiest period so far is 2020 onward with 308 records.

Reviews account for 42 records (13.6%) and meta-analyses for 7. Randomized controlled trials number 2 (0.6%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.

PubMed records by publication periodthrough 1999: 0 records; 2000-2009: 0 records; 2010-2019: 6 records; 2020 onward: 308 records0through 199902000-200962010-20193082020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19990
2000-20090
2010-20196
2020 onward308
Share of records by publication typeReviews: 13.6 percent; Meta-analyses: 2.3 percent; Randomized controlled trials: 0.6 percentReviews13.6% (42)Meta-analyses2.3% (7)Randomized controlled trials0.6% (2)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 309 PubMed records
TypeRecordsShare
Reviews4213.6%
Meta-analyses72.3%
Randomized controlled trials20.6%

Method: PubMed query "Ovarian Torsion"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.

Reading the evidence in metabolism and endocrine disease

Studies of diabetes, obesity and hormone disorders often follow blood tests such as glucose, HbA1c or hormone levels, which are stand-ins for outcomes that matter more, such as complications. Lifestyle and diet research is largely observational, and weight and diabetes trials can differ in how long people were followed. Nothing on this page is advice about medicines, insulin or diet; talk to a qualified clinician about your own situation. Check whether the outcome was a lab value or a clinical event, and the type and duration of the condition studied.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study
Wang YX, Deng S
2020Research article
Design not recorded in structured metadata
17cc by
PMID 32831043 · DOI · PMC7444049
Effect of metformin and detorsion treatment on serum anti-Müllerian hormonelevels and ovarian histopathology in a rat ovarian torsion model
Karakaş S, Kaya C, Güraslan H, Sakiz D, Süzen Çaypinar S, Cengiz H, et al.
2020Research article
Design not recorded in structured metadata
13cc by
PMID 31999406 · DOI · PMC7164755
Predictive Role of Neutrophil to Lymphocyte Ratio in Adnexal Torsion: A Systematic Review and Meta-Analysis
Khanzadeh S, Tahernia H, Hernandez J, Sarcone C, Lucke-Wold B, Salimi A, et al.
2022Meta-analysis
Design not recorded in structured metadata
7cc by
PMID 36387932 · DOI · PMC9649322
Improving diagnostic accuracy of ovarian torsion using contrast-enhanced ultrasound: A prospective comparative clinical study of performance diagnosis
Fijean AL, Hossu G, Cherifi A, Beaumont M, Morel O, Bertholdt C
2026Research article
Design not recorded in structured metadata
3cc by
PMID 40761032 · DOI · PMC12790659

Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study [1]

Research article Wang YX, Deng S · · 2020 · cited 17 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundAdnexal torsion during pregnancy is a gynecological emergency.
Closing excerpt
Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (198 words)

BackgroundAdnexal torsion during pregnancy is a gynecological emergency. Delayed diagnosis and treatment can cause ovarian necrosis and fetal loss. This study assessed the clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women.MethodsA retrospective study was conducted at a tertiary center between January 2008 and January 2018. Eighty-two pregnant women with surgically confirmed adnexal torsion were included. The clinical characteristics, ultrasound data, surgical interventions and pregnancy outcomes were analyzed.ResultsThe median age of the patients was 28 (range, 18-38) years. The median gestational age was 11 (range, 6-31) weeks: 53 (64.6%) were in the first trimester, 21 (25.6%) were in the second trimester, and 8 (9.8%) were in the third trimester. The most common symptoms and signs were sudden pelvic pain (100%) and adnexal or pelvic masses (97.6%), followed by nausea and vomiting (61%). The Doppler blood flow signal disappeared in 62.5% of the patients. Sixty-three (76.8%) patients underwent laparoscopy, and 29 (24.2%) underwent laparotomy. The median gestational age in patients undergoing laparotomy was higher than that in those undergoing laparoscopy (26 weeks vs 10 weeks, p ConclusionSurgical intervention was required as soon as possible. Laparoscopic conservative surgery is safe and may be appropriate to preserve ovarian function.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32831043 · DOI · PMC7444049

Effect of metformin and detorsion treatment on serum anti-Müllerian hormonelevels and ovarian histopathology in a rat ovarian torsion model [2]

Research article Karakaş S, Kaya C, Güraslan H, Sakiz D, Süzen Çaypinar S, Cengiz H, et al. · · 2020 · cited 13 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Background/aimAdnexal torsion is a common gynaecological emergency, and considered to be a problem mostly in reproductive-age women.
Closing excerpt
ConclusionMetformin+detorsion treatment may be effective in protecting the ovarian reserve after ovarian torsion.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (184 words)

Background/aimAdnexal torsion is a common gynaecological emergency, and considered to be a problem mostly in reproductive-age women. To evaluatethe effect of metformin and detorsion treatment on reducing ovarian reserve in an ovarian torsion model.Materials and methodsTwenty-four nonpregnant, Wistar Hannover rats were included in the study. Animals were divided into 3 groups: the control group, the detorsion only group, and the metformin + detorsion group. The first group received only laparotomy. In the second group, ovaries were fixed to the abdominal wall after performing 360° ovarian torsion, followed by detorsion after a 3-h period of ischemia. The third group underwent the same torsion and detorsion procedures as the second group, and received 50 mg/kg metformin by gavage for 14 days. Ovarian damage scores, follicle counts, and AMH levels were evaluated.ResultsThe total damage score was significantly increased in the detorsion only group compared to the metformin+detorsion and control groups. Pre-operative/post-operative AMH decreases were statistically significant in negative direction in the detorsion only group when compared to the metformin+detorsion and control groups (P = 0.001).ConclusionMetformin+detorsion treatment may be effective in protecting the ovarian reserve after ovarian torsion.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 31999406 · DOI · PMC7164755

Predictive Role of Neutrophil to Lymphocyte Ratio in Adnexal Torsion: A Systematic Review and Meta-Analysis [3]

Meta-analysis Khanzadeh S, Tahernia H, Hernandez J, Sarcone C, Lucke-Wold B, Salimi A, et al. · · 2022 · cited 7 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
IntroductionThe goal of this systematic review and meta-analysis was to consolidate the available data on the role of the neutrophil to lymphocyte ratio (NLR) in predicting adnexal torsion (AT), to help guide clinical decision-making and outcomes.
Closing excerpt
ConclusionIn conclusion, there has been an interest in the use of NLR as a diagnostic marker for AT.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (176 words)

IntroductionThe goal of this systematic review and meta-analysis was to consolidate the available data on the role of the neutrophil to lymphocyte ratio (NLR) in predicting adnexal torsion (AT), to help guide clinical decision-making and outcomes.MethodsWe used Web of Science, PubMed, and Scopus to conduct a systematic search for relevant publications published before June 26, 2022. We reported standardized mean difference (SMD) with a 95% confidence interval (CI). Because a significant level of heterogeneity was found, we used the random-effects model to calculate pooled effects. We used the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) too for quality assessment.ResultsOverall, 15 articles were included in the analysis. A random-effects model revealed that patients with AT had elevated levels of NLR compared to those with other adnexal masses (SMD = 1.06, 95%CI = 0.67 to 1.45, p p p = 0.11). The pooled sensitivity of NLR was 0.79 (95%CI = 0.72-0.85), and the pooled specificity was 0.84 (95% CI, 0.74-0.91).ConclusionIn conclusion, there has been an interest in the use of NLR as a diagnostic marker for AT.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 36387932 · DOI · PMC9649322

Improving diagnostic accuracy of ovarian torsion using contrast-enhanced ultrasound: A prospective comparative clinical study of performance diagnosis [4]

Research article Fijean AL, Hossu G, Cherifi A, Beaumont M, Morel O, Bertholdt C · · 2026 · cited 3 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
ObjectiveThis study evaluates the diagnostic performance of contrast-enhanced ultrasound (CEUS) for improving diagnosis of adnexal torsion in women with acute abdominal pain.
Closing excerpt
ConclusionThe diagnostic performance of CEUS to diagnose adnexal torsion is high.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (159 words)

ObjectiveThis study evaluates the diagnostic performance of contrast-enhanced ultrasound (CEUS) for improving diagnosis of adnexal torsion in women with acute abdominal pain.MethodsThis was a pilot study of the diagnostic accuracy of CEUS for the detection of adnexal torsion. All women in our center with planned surgery for suspicion of adnexal torsion were included. The final diagnosis was confirmed during surgical intervention to classify "torsion" and "control" groups. Qualitative imaging analyses were performed blindly of the final diagnosis by an expert and nonexpert obstetrician and gynecologist (Obgyn).ResultsSix ovaries were included in the torsion group and eight ovaries in the control group. A total of 476 images from 14 included cases were analyzed by one expert and 34 ObGyn. The sensitivity was 100% (confidence interval [CI] 95% [59-100]) and 84.3% (CI 95% [78.7-88.9]) and the specificity 86% (CI 95% [42-100]) and 89.8% (CI 95% [85.4-93.2]) for expert and nonexpert Obgyn, respectively.ConclusionThe diagnostic performance of CEUS to diagnose adnexal torsion is high.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40761032 · DOI · PMC12790659

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Accuracy of imaging modalities for adnexal torsion: a systematic review and meta-analysis [5]
    Wattar B, Rimmer M, Rogozinska E, Macmillian M, Khan KS, Al Wattar BH · BJOG · 2021 · cited 43 times (Europe PMC)
  • Research article Diagnostic value of the sonographic whirlpool sign in the diagnosis of ovarian torsion: A systematic review and meta-analysis [6]
    Adu-Bredu TK, Arkorful J, Appiah-Denkyira K, Wiafe YA · J Clin Ultrasound · 2021 · cited 12 times (Europe PMC)
  • Research article Malignant transformation arising from mature cystic teratoma of the ovary presenting as ovarian torsion: a case report and literature review [7]
    Toba N, Takahashi T, Ota K, Takanashi A, Iizawa Y, Endo Y, et al. · Fukushima J Med Sci · 2020 · cited 12 times (Europe PMC)
  • Research article Multimodality imaging review for suspected ovarian torsion cases in children [8]
    Gounder S, Strudwick M · Radiography (Lond) · 2021 · cited 10 times (Europe PMC)
  • Research article Pediatric Ovarian Torsion: Should You Go With the Flow? [9]
    Sims MJ, Price AB, Hirsig LE, Collins HR, Hill JG, Titus MO · Pediatr Emerg Care · 2022 · cited 8 times (Europe PMC)
  • Research article Ovarian Torsion: A Review of the Evidence [10]
    Zhu TW, Li XL · Obstet Gynecol Surv · 2024 · cited 4 times (Europe PMC)

References

  1. Wang YX, Deng S. Clinical characteristics, treatment and outcomes of adnexal torsion in pregnant women: a retrospective study. . 2020. PMID 32831043 · DOI · PMC7444049
  2. Karakaş S, Kaya C, Güraslan H, Sakiz D, Süzen Çaypinar S, Cengiz H, et al.. Effect of metformin and detorsion treatment on serum anti-Müllerian hormonelevels and ovarian histopathology in a rat ovarian torsion model. . 2020. PMID 31999406 · DOI · PMC7164755
  3. Khanzadeh S, Tahernia H, Hernandez J, Sarcone C, Lucke-Wold B, Salimi A, et al.. Predictive Role of Neutrophil to Lymphocyte Ratio in Adnexal Torsion: A Systematic Review and Meta-Analysis. . 2022. PMID 36387932 · DOI · PMC9649322
  4. Fijean AL, Hossu G, Cherifi A, Beaumont M, Morel O, Bertholdt C. Improving diagnostic accuracy of ovarian torsion using contrast-enhanced ultrasound: A prospective comparative clinical study of performance diagnosis. . 2026. PMID 40761032 · DOI · PMC12790659
  5. Wattar B, Rimmer M, Rogozinska E, Macmillian M, Khan KS, Al Wattar BH. Accuracy of imaging modalities for adnexal torsion: a systematic review and meta-analysis. BJOG. 2021. PMID 32570294 · DOI
  6. Adu-Bredu TK, Arkorful J, Appiah-Denkyira K, Wiafe YA. Diagnostic value of the sonographic whirlpool sign in the diagnosis of ovarian torsion: A systematic review and meta-analysis. J Clin Ultrasound. 2021. PMID 34021602 · DOI
  7. Toba N, Takahashi T, Ota K, Takanashi A, Iizawa Y, Endo Y, et al.. Malignant transformation arising from mature cystic teratoma of the ovary presenting as ovarian torsion: a case report and literature review. Fukushima J Med Sci. 2020. PMID 32161199 · DOI · PMC7269886
  8. Gounder S, Strudwick M. Multimodality imaging review for suspected ovarian torsion cases in children. Radiography (Lond). 2021. PMID 32713824 · DOI
  9. Sims MJ, Price AB, Hirsig LE, Collins HR, Hill JG, Titus MO. Pediatric Ovarian Torsion: Should You Go With the Flow?. Pediatr Emerg Care. 2022. PMID 35639437 · DOI
  10. Zhu TW, Li XL. Ovarian Torsion: A Review of the Evidence. Obstet Gynecol Surv. 2024. PMID 39136639 · DOI

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-11-04.

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At a glance

309
PubMed records on this heading
100%
published since 2020
42
review articles
2
randomized trials
10
verified references below

Counts come from PubMed on 2026-11-04; they show how much has been written, not how strong the evidence is.

Related topics See all →

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  • OophoritisMetabolism and Endocrine Disease

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