title: Adnexal Incarceration in a Posterior Pelvic Peritoneal Defect Mimics Ovarian Torsion.
abstract: Surgery for suspected ovarian torsion sometimes reveals unexpected sources of pelvic pain, such as internal hernias, adhesions, or anatomic defects. A 23-year-old nulligravida with Alagille syndrome was taken to the operating room with suspected ovarian torsion. Intraoperatively, the right adnexa bulged out of a right-sided, posterior peritoneal cleft that incarcerated most of the enlarged ovary. No ovarian torsion was identified. The left adnexa appeared to be normal; however, it dwelled within a left-sided posterior peritoneal cleft. The bilateral posterior peritoneal defects that housed the adnexa were likely of congenital etiology. Although adnexal incarceration is a rare finding at surgery for suspected ovarian torsion, it should be part of the differential diagnosis when evaluating acute pelvic pain.
authors.affiliation: Department of Obstetrics & Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland. Electronic address: Amanda.M.Jackson50.mil@mail.mil.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Jackson
authors.affiliation: Department of Obstetrics & Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Erica R
authors.initials: ER
authors.lastname: Hope
authors.affiliation: Department of Obstetrics & Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Neil T
authors.initials: NT
authors.lastname: Phippen
mesh_terms: D000290:Adnexa Uteri / Q000601:surgery*; D000291:Adnexal Diseases / Q000175:diagnosis* / Q000601:surgery; D000328:Adult; D016738:Alagille Syndrome / Q000150:complications* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000175:diagnosis* / Q000601:surgery; D017699:Pelvic Pain / Q000209:etiology* / Q000601:surgery; D010537:Peritoneum / Q000601:surgery; D014102:Torsion Abnormality / Q000175:diagnosis* / Q000601:surgery; D016896:Treatment Outcome
keywords: Adnexal incarceration; Adnexal mass; Alagille syndrome; Ovarian torsion; Peritoneal defect