Concurrent Appendicitis and Ovarian Torsion in a Postmenopausal Patient

Appendicitis and ovarian torsion are emergent diagnoses that cause acute pain. Appendicitis can be classified clinically by an elevated white blood cell count, elevated C-reactive protein values, and tenderness around McBurney’s point. Ovarian torsion is often clinically characterized by sudden, intense pelvic pain due to the ovarian vessels or fallopian tube twisting and compromising blood flow to the ovary. This case study outlines simultaneous appendicitis and ovarian torsion in a postmenopausal woman with a prior hysterectomy. It illustrates how sonographic imaging can be valuable in making a torsion and appendicitis diagnosis. Sonography can be valuable in diagnosing ovarian torsion due to its Doppler capabilities and ability to directly visualize adnexal structures. Despite its technically challenging nature, the appendix can also be identified in adults via sonographic methods. This case is especially important for sonographers and clinicians, as ovarian torsion is not commonly considered in the postmenopausal patient population.