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Ovarian torsion — MCCQE Part 1 MCQ

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ModeratePelvic PainOvarian torsionMCCQE Part 1

A 19-year-old woman has sudden severe unilateral pelvic pain with vomiting. Pregnancy test is negative and ultrasound shows an enlarged ovary with reduced Doppler flow. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Urgent gynaecologic laparoscopy for detorsion

Sudden unilateral pelvic pain with vomiting and enlarged ovary suggests torsion, requiring urgent surgical detorsion to preserve ovarian function. Doppler findings can be imperfect, so clinical suspicion remains key. Antibiotics or contraception do not treat torsion.

Reference: SOGC adnexal torsion practice; provincial gynaecology emergency pathways