Ovarian Torsion

Renal colic mimics

EMKF

 

  • Some mimics of renal colic that may arrive at the ED include: upper UTI’s, ectopic pregnancies, ovarian torsion, adnexal masses, testicular torsion, acute aortic syndromes, renal artery aneurysms, renal infarction, splenic infarction, bowel obstruction, diverticulitis, appendicitis, biliary colic, cholecystitis, acute intestinal ischemia, pneumonia, pulmonary embolism, retroperitoneal hematoma, iliopsoas abscess.
  • Focused history and physical exam are paramount due to the multitude of structures in the area and potentially dangerous conditions that may mimic renal colic.
  • Flank pain and hematuria are the hallmarks of renal colic, however, the presentation is variable.
  • Diagnosis can be confirmed with CT scan, which will show most other potential items in the differential if the scan is negative for a stone.

 

Ovarian Torsion

EMKF

Abdominal pain

The most common presenting symptom is pelvic pain followed by the history of or a palpable adnexal mass on physical exam. Patients typically present 1 to 3 days after onset, although patients with intermittent torsion can present at any time. Abdominal pain can be characterized as sharp, stabbing, and colicky, and it can possibly radiate to the flank, back, or into the pelvis and upper thigh.