Auslender et al classified changes of adnexal torsion seen on Doppler and gray-scale sonography. These changes can aid clinical decision-making. The authors are from the Lady Davis Carmel Medical Center in Haifa, Israel.
Patient selection: woman with acute abdominal pain
Patient evaluation: Doppler and gray-scale ultrasonography
Parameters:
(1) blood vessel appearance
(2) arterial blood flow
(3) venous blood flow
Blood Vessels
Venous Flow
Arterial Flow
Class
normal
normal
normal
0
coiling
present
present
1
coiling
absent
present
2
coiling
absent
absent
3
where:
• “Coiling” refers to a spiral rotation of the ovarian pedicles with a twisting of the blood vessels into the shape of a coil.
Class
Findings
Management
0
normal
Monitor the patient.
1
normal or mildly enlarged ovary, little or no peritoneal fluid, lack of necrosis, favorable outcome
Conservative if possible.
2
enlarged and edematous ovary, mild to moderate free peritoneal fluid, follicular halos, reduced ovarian viability
Requires surgery.
3
ischemic or necrotic ovary
Requires urgent surgery.
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