While studying abroad in South Korea, N.T.T.M. (23) experienced unusual pain in her lower right abdomen. She sought treatment at a local hospital and received medication for a suspected digestive issue.

After returning to Vietnam to visit her family, the pain recurred and worsened. On her friends’ advice, M. visited FV Hospital for evaluation.

She was first assessed by the Gastroenterology Department. Noting unusual features, the attending doctor referred her to the Emergency Department. A gynaecological ultrasound revealed right ovarian torsion with a 9 cm dermoid cyst, as well as an additional mass in the left ovary.

Dr Nguyen Duc Truong of the FV Thomson Maternity Department examining patient M. after surgery. Image: FV Hospital

A 9 cm tumour causes complete double ovarian torsion

Ovarian torsion occurs when the ovary rotates around its supporting ligament, compressing the blood vessels and reducing blood flow. Without prompt treatment, the ovary is at risk of tissue death (necrosis).

Dr Nguyen Duc Truong, Senior Consultant at FV Thomson Maternity Department, explained that in M.’s case, the large tumour caused the torsion.

“Tumours measuring 6 cm or larger carry a significantly increased risk of torsion. The presence of the mass alters the structure and weight of the ovary, increasing its mobility,” he said.

When M. arrived at FV, she had been in pain for over 24 hours. Due to the risk to the ovary’s blood supply, doctors determined that urgent detorsion surgery was necessary.

For a 23-year-old patient, the challenge was not only to address the emergency but also to remove the tumour while preserving the ovary and her reproductive function.

Dr Nguyen Duc Truong and his surgical team performing laparoscopic surgery on the patient. Image: FV Hospital

A single operation, addressing both the torsion and two tumours

Before surgery, the surgical team thoroughly explained M.’s condition and treatment plan. As this was her first operation, she understandably felt anxious.

“This was my first time having surgery, and I was extremely anxious. But once Dr Truong reassured me and explained the treatment process, the likely recovery, and the very high success rate, I felt much more at ease,” M. shared.

The FV Thomson Maternity team performed emergency laparoscopic surgery. Through small incisions in the umbilicus and abdomen, they found the right ovary had a double torsion with severe blood vessel compression.

The team performed detorsion, allowed swelling to subside, then removed the cyst. The left ovarian mass was also treated during the same procedure.

After 2 hours and 45 minutes, the team addressed both issues in one procedure: detorsion of the ovary and removal of both cysts.

This approach was especially important for a young patient, as it aimed to manage the emergency and preserve reproductive organs whenever possible.

Following surgery, M. recovered well. Her doctors confirmed that both ovarian and reproductive function were preserved, with minimal long-term impact.

“I feel great now. The pain is completely gone. I feel very fortunate to have chosen FV,” M. shared.

Patient M. recovers well following her surgery. Image: FV Hospital

Unusual lower abdominal pain: Do not assume it’s only a digestive issue

M.’s case highlights that ovarian torsion can cause pain easily mistaken for gastrointestinal or renal conditions.

Dr Nguyen Duc Truong recommends that all women, including younger women, have an annual gynaecological examination, ideally with pelvic ultrasound to assess the uterus and ovaries. If a mass is found, patients should receive specialist assessment and regular follow-up every 3-6 months to monitor progression and determine appropriate management, especially if complications are possible.

If unusual lower abdominal pain develops, worsens, becomes more severe the next day, or persists for several days, patients should seek medical assessment rather than monitoring at home.

In suspected ovarian torsion, early detection and treatment are essential to limit ischaemic damage and preserve the ovary.

What began as pain resembling a digestive complaint was correctly identified and managed at FV due to timely detection and treatment. This case demonstrates that emergency gynaecological care should address both immediate risks and long-term reproductive health, especially for younger patients.

For more information on treatment of ovarian torsion, please contact the FV Thomson Maternity Department at FV Hospital, 6 Nguyen Luong Bang Street, Tan My Ward (formerly District 7), Ho Chi Minh City, or call (028) 3511 3333.

FV Hospital offers a wide range of financial support options, coordinating Social Health Insurance (BHYT), private health insurance, and instalment payment plans for all outpatient, inpatient, and emergency services.