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Case Studies | Radiology and Medical Imaging Sciences | Volume 15 Issue 4, April 2026 | Pages: 657 - 661 | India
The Ovary that Fooled the Hip: A Twisted Dermoid Tale - A Case Report
Abstract: Background: Ovarian torsion is a time-sensitive gynecological emergency that commonly presents with acute lower abdominal pain but may exhibit atypical clinical features, leading to diagnostic challenges. It is most commonly linked to adnexal masses, especially dermoid cysts (mature cystic teratomas), which, because of their size and weight, put the ovary at risk for torsion. In order to maintain fertility and avoid irreparable ovarian damage, early detection is essential. Atypical presentations, such as referred hip or thigh pain, might, however, be mistaken for non-gynecological disorders and postpone proper treatment. Case Presentation: We report the case of a 35-year-old female who presented with acute onset severe right lower abdominal pain radiating to the right hip for 4 hours. There were no associated symptoms such as fever, nausea, or vomiting, and her last menstrual period was 15 days prior. Clinical examination revealed localized right iliac fossa tenderness. Ultrasonography demonstrated a well-defined right adnexal solid cystic lesion measuring approximately 7 cm with echogenic components and posterior acoustic shadowing, with right ovary not seen separately from it, suggestive of a dermoid cyst. The right ovary appeared enlarged and edematous with minimal to absent vascularity on Doppler, and a twisted vascular pedicle (whirlpool sign) was identified. Additionally, moderate free fluid in the pouch of Douglas was noted. The uterus was normal with a trilaminar endometrium. Based on these findings, a diagnosis of right ovarian torsion secondary to a dermoid cyst was established, and the patient was referred for urgent surgical management.
Keywords: dermoid cyst, ovarian torsion, acute abdominal pain, Doppler ultrasound, gynecological emergency
How to Cite?: Dr. Himanshi Masand, Dr. Rushikesh Pokale, "The Ovary that Fooled the Hip: A Twisted Dermoid Tale - A Case Report", Volume 15 Issue 4, April 2026, International Journal of Science and Research (IJSR), Pages: 657-661, https://www.ijsr.net/getabstract.php?paperid=SR26408122559, DOI: https://dx.dx.doi.org/10.21275/SR26408122559