Adnexal Torsion During the Postpartum Period: A Case Report

Ovarian torsion (OT) is a relatively uncommon gynecological emergency, and its occurrence in the postpartum period is even rarer. This case report presents the unique clinical journey of a 29-year-old woman who was urgently referred for pelvic pain on postpartum day 20 following an unmonitored home birth. Despite the absence of specific symptoms, the patient's condition deteriorated rapidly, prompting medical attention. Clinical evaluation revealed a distended abdomen with diffuse tenderness and a palpable abdominal mass. imaging through ultrasound and abdominopelvic CT scan disclosed a massive cystic mass with suspected ovarian torsion. Prompt surgical intervention via laparotomy confirmed the diagnosis, revealing a voluminous cyst originating from the right ovary with a three-fold spiral torsion and intracystic hemorrhage. Subsequent adnexectomy of the left ovary was necessary due to its necrotic appearance, resulting in a 16 kg surgical specimen. This case underscores the importance of considering ovarian torsion in the differential diagnosis of postpartum pelvic pain and highlights the challenges in diagnosing this condition given its rarity and non-specific presentation. Early recognition and timely intervention are essential to preserve ovarian function and ensure optimal patient outcomes.