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Ovarian torsion explained: How an intense lower abdominal pain sent a woman straight to emergency surgery

Experts say ovarian torsion is one such condition that can quickly become life-threatening if ignored

Representative image | Shutterstock

Women often dismiss abdominal pain as acidity, indigestion, or “just a stomach issue.” But in some cases, sudden severe pain can signal a serious gynaecological emergency that requires immediate treatment.

Dr Shobhika Selvaraj, Consultant, Obstetrics & Gynaecology, says ovarian torsion is one such condition that can quickly become life-threatening if ignored.

“Ovarian torsion happens when the ovary twists around itself, cutting off its own blood supply. The pain is usually sudden and severe, and delaying treatment can lead to tissue damage and other serious complications,” she explains.

A case that highlighted the risk

A 56-year-old woman was brought to Manipal Hospital, Sarjapur Road, with intense lower abdominal pain that had started suddenly, without any major warning signs.

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Initial investigations, including a CT scan, revealed a large ovarian mass with torsion. The twisted ovary had already compromised blood flow, making it a surgical emergency. There was also concern about a possible underlying malignancy.

“She came in with only one symptom, severe pain, but internally, it was a critical situation. In such cases, every minute matters,” says Dr Shobhika. The patient was immediately taken up for surgery, initially planned as an open cystectomy. Yet, at the time of operation, certain characteristics were observed in the ovarian mass suggestive of mucinous cystadenoma, which implied a certain oncological hazard and necessitated an expansion of surgical procedures.

Oncologically extensive surgery was carried out; it included total hysterectomy, removal of both fallopian tubes and ovaries, excision of the pelvic and para-aortic lymph nodes, as well as omentectomy and biopsy of the peritoneum.

According to the attending surgeons, the timing of the operation played a crucial role since if the cyst had burst open within the abdomen, the patient would likely encounter considerable complications.

Why similar cases are often missed

Doctors say many ovarian masses grow silently and may not show noticeable symptoms in the early stages. In several women, mild bloating, pelvic discomfort, or changes in digestion are often mistaken for routine gastric issues or age-related changes, leading to delays in diagnosis and treatment.

Symptoms women should not ignore

Doctors say ovarian conditions can often remain silent for long periods, especially in postmenopausal women, where the risk of malignancy is higher.

Warning signs may include:

• Sudden severe abdominal or pelvic pain

• Persistent bloating

• Abdominal heaviness

• Nausea or vomiting

• Unexplained changes in appetite or digestion

“A lot of women tend to normalise pain or delay consultations. But sudden abdominal pain should never be ignored, especially after menopause,” says Dr Shobhika.

The patient recovered well after surgery and was monitored closely in the ICU before discharge. This case is a reminder that sometimes a single symptom can uncover a much deeper health issue, and timely medical attention can make all the difference.