Acute Abdomen Torsion Teratoma

Clinical case in gynecological emergencies In this case it is striking that although the patient had previously had a picture of self-limited pelvic pain 10 days before with diarrhea, and a few seconds "loss of consciousness", it was on the day of the consultation. Being previously asymptomatic, the sudden increase in intra-abdominal pressure triggers the acute clinical presentation. There were no changes in menstrual pattern, genital bleeding or general symptoms (chills, fever sensation) or upper / lower digestive and urinary symptoms. The anamnesis together with the clinical examination (abdominal and combined) already allow a first diagnostic approach to an acute mechanical pelvic picture. Complementary tests: Normal temperature, and basic blood tests increase the diagnostic probability. The ultrasound examination (transvaginal) and the complement (requested in general emergencies) X-ray of the abdomen allow to further specify the clinical judgment of a twisted ovarian tumor (teratoma). Laparoscopy confirms the diagnosis. The therapeutic decision was facilitated by the age of the patient and especially her fulfilled genetic wishes. Would the same intervention - adnexectomy - have been correct in the case of a 24-year-old woman without children and with the desire to have them?