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Ovarian torsion — MCCQE Part 1 MCQ

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HardPelvic PainOvarian torsionMCCQE Part 1

A 25-year-old woman presents with sudden right pelvic pain, vomiting, and a history of a 7 cm ovarian cyst. She is afebrile, pregnancy test is negative, and Doppler ultrasound shows an enlarged ovary with peripheral follicles and reduced venous flow. What is the most appropriate next step in management?

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Correct answer: C — Urgent gynaecologic laparoscopy

Ovarian torsion is suggested by sudden pain, vomiting, ovarian enlargement, cyst risk factor, and abnormal Doppler flow; urgent laparoscopy is required to preserve ovarian function. Antibiotics would treat PID, which is less likely without fever or discharge and does not address torsion. Hormonal suppression and delayed imaging risk ovarian necrosis. Colonoscopy is not an acute test here.

Reference: SOGC adnexal torsion guidance