Report of a Case with Simultaneous Ovarian Cyst Torsion and Ectopic Pregnancy in the Right Adnexa after Spontaneous Pregnancy

BACKGROUND AND OBJECTIVE: Ovarian torsion and ectopic pregnancy occur in 2.7 and 2% of all pregnancies, respectively, and both are known as gynecologic emergencies. The simultaneous occurrence of these two cases is rare. This study reports a case with simultaneous ovarian torsion and ectopic pregnancy. CASE REPORT: The patient is a 31-year-old woman with history of two abortions, who referred with a history of 6-week missed menstrual period and vaginal bleeding from one day before and abdominal colic pain accompanied by two occasions of nausea and vomiting. In ultrasonography, cyst was reported to be 54 × 60 mm in right ovary and moderate free fluid was found in cul de sac, while serum HCGβ levels were more than 1000. Due to the exacerbation of abdominal pain, emergency laparotomy was performed, which revealed ruptured ectopic pregnancy and ovarian torsion with active bleeding and a 7×6 cm cyst in the same side with two rounds of torsion. Open torsion, right salpingectomy and cystectomy were performed. The patient was discharged 48 hours after the operation with a good general condition and without serious complication, and there was no problem during the 6-week postoperative follow-up. CONCLUSION: Simultaneous occurrence of ovarian torsion and ectopic pregnancy is rare, but it is likely to occur. Therefore, early diagnosis to maintain future pregnancies and preserve the ovary is important and suitable medical measures may prevent the unwanted side effects in these patients.