Torsion of a pregnancy luteoma in a twin gestation: a rare case of acute abdomen managed by laparotomy

Abstract

Ovarian torsion is a cause of acute abdomen in pregnancy which usually ends in surgical intervention especially in the first half of pregnancy. Treatment dilemma ensues in twin gestation due to an increased risk of pregnancy loss from the twin pregnancy itself, as a complication of the ovarian torsion, and also from the surgical treatment. This is especially so in low resource settings like Nigeria where laparoscopic surgical treatment is not readily available. We present the case of a 25-year-old multipara with twin pregnancy admitted at 16 weeks gestation with acute abdomen due to ovarian torsion. She had emergency laparotomy with right salpingo-oophorectomy. The histological diagnosis of luteoma is a rare cause of ovarian cysts in pregnancy, with not many documented cases. The pregnancy was subsequently managed to 35 weeks gestation when she had caesarean delivery of live twin infants, with no complications.