ICD-10: N83.51

Clinical Description of ICD-10 Code N83.51: Torsion of Ovary and Ovarian Pedicle

ICD-10 code N83.51 specifically refers to the condition known as torsion of the right ovary and ovarian pedicle. This medical condition is characterized by the twisting of the ovary and its supporting structures, which can lead to compromised blood flow and potential necrosis of the ovarian tissue if not addressed promptly.

Pathophysiology

Ovarian torsion occurs when the ovary rotates around its vascular pedicle, which contains the ovarian artery and vein. This twisting can obstruct blood flow, resulting in ischemia (lack of blood supply) and, if not resolved, can lead to tissue death. The condition is often acute and requires immediate medical intervention to restore blood flow and prevent irreversible damage.

Clinical Presentation

Patients with ovarian torsion typically present with:

• Sudden Onset of Severe Pelvic Pain: The pain is often unilateral and may be accompanied by nausea and vomiting.
• Abdominal Tenderness: Physical examination may reveal tenderness in the lower abdomen, particularly on the affected side.
• Possible Fever: In some cases, a low-grade fever may be present, indicating an inflammatory response.
• Changes in Menstrual Cycle: Some patients may report changes in their menstrual cycle or abnormal vaginal bleeding.

Diagnosis

Diagnosis of ovarian torsion is primarily clinical but is supported by imaging studies. Common diagnostic methods include:

• Ultrasound: A pelvic ultrasound, particularly with Doppler studies, can help assess blood flow to the ovary and identify the presence of an enlarged, edematous ovary.
• CT Scan: In some cases, a CT scan may be utilized to rule out other causes of acute abdominal pain.

Treatment

The primary treatment for torsion of the ovary is surgical intervention. Options include:

• Laparoscopy: This minimally invasive procedure allows for direct visualization of the ovaries and the ability to untwist the affected ovary. If the ovary is viable, it may be fixed in place to prevent recurrence.
• Oophorectomy: In cases where the ovary is necrotic and non-viable, surgical removal of the affected ovary may be necessary.

Prognosis

The prognosis for patients with ovarian torsion largely depends on the timeliness of diagnosis and treatment. If treated within a few hours, the ovary can often be salvaged, preserving its function. However, delays in treatment can lead to loss of the ovary and associated complications.

Conclusion

ICD-10 code N83.51 encapsulates a critical condition in gynecological health that requires prompt recognition and intervention. Understanding the clinical presentation, diagnostic methods, and treatment options is essential for healthcare providers to manage this potentially life-altering condition effectively. Early intervention is key to preserving ovarian function and preventing complications associated with torsion.

Torsion of the ovary and ovarian pedicle, classified under ICD-10 code N83.51, is a critical condition that requires prompt diagnosis and management. This condition occurs when the ovary twists around the ligaments that support it, potentially compromising its blood supply. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is essential for effective diagnosis and treatment.

Clinical Presentation

Signs and Symptoms

The clinical presentation of ovarian torsion can vary, but it typically includes the following key signs and symptoms:

• Acute Onset of Abdominal Pain: Patients often report sudden, severe unilateral abdominal or pelvic pain. This pain may be sharp and can radiate to the lower back or thigh[1][2].
• Nausea and Vomiting: Accompanying the pain, patients frequently experience gastrointestinal symptoms such as nausea and vomiting, which can complicate the clinical picture[2][3].
• Abdominal Tenderness: Physical examination usually reveals tenderness in the affected area, often localized to the adnexa[3].
• Fever: In some cases, patients may present with a low-grade fever, indicating a possible inflammatory response[2].
• Changes in Menstrual Cycle: Some patients may report changes in their menstrual cycle, including amenorrhea or abnormal bleeding, particularly if the torsion is associated with an underlying cyst or mass[1].

Physical Examination Findings

During a physical examination, healthcare providers may observe:

• Adnexal Tenderness: Tenderness upon palpation of the adnexa is a common finding.
• Mass Effect: In some cases, a palpable adnexal mass may be noted, which could indicate an enlarged or twisted ovary[3].
• Rebound Tenderness: This may be present if there is associated peritoneal irritation due to inflammation or necrosis[2].

Patient Characteristics

Demographics

Ovarian torsion can occur in women of any age, but certain demographic factors are more commonly associated with the condition:

• Age: It is most frequently seen in women of reproductive age, particularly between the ages of 20 and 40. However, it can also occur in adolescents and postmenopausal women[1][4].
• Risk Factors: Several risk factors may predispose individuals to ovarian torsion, including:
• Ovarian Cysts or Masses: The presence of functional or pathological ovarian cysts can increase the risk of torsion due to the added weight and mobility of the ovary[2][4].
• Previous Pelvic Surgery: A history of pelvic surgery may alter the anatomy and increase the likelihood of torsion[3].
• Hypermobile Ovaries: Some women may have anatomical variations that predispose their ovaries to torsion, such as a longer ovarian ligament[1].

Clinical Context

Ovarian torsion is often a surgical emergency. Delayed diagnosis and treatment can lead to ovarian necrosis and loss of function, making early recognition of symptoms critical. The condition may be mistaken for other acute abdominal conditions, such as appendicitis or ectopic pregnancy, which can complicate the clinical approach[2][3].

Conclusion

In summary, ovarian torsion (ICD-10 code N83.51) presents with acute abdominal pain, nausea, vomiting, and tenderness in the adnexal region. It predominantly affects women of reproductive age, particularly those with risk factors such as ovarian cysts or a history of pelvic surgery. Prompt recognition and intervention are crucial to prevent complications, including loss of the affected ovary. If you suspect ovarian torsion, immediate medical evaluation is essential to ensure appropriate management and care.

The ICD-10 code N83.51 specifically refers to "Torsion of right ovary and ovarian pedicle." This condition occurs when the ovary twists around the ligaments that hold it in place, potentially compromising its blood supply and leading to severe pain and other complications. Understanding alternative names and related terms for this condition can enhance clarity in medical documentation and communication.

Alternative Names for Torsion of Ovary

1. Ovarian Torsion: This is the most commonly used term and refers to the twisting of the ovary itself, which can occur on either side (right or left).
2. Adnexal Torsion: This term encompasses torsion of both the ovary and the surrounding structures, including the fallopian tube.
3. Ovarian Pedicle Torsion: This term highlights the twisting of the ovarian pedicle, which includes the blood vessels and ligaments that support the ovary.
4. Twisted Ovary: A more colloquial term that may be used in patient discussions or educational materials.

Related Terms

1. Acute Abdomen: Torsion of the ovary can present as an acute abdomen, a medical emergency requiring immediate evaluation.
2. Pelvic Pain: This is a common symptom associated with ovarian torsion, often leading to further investigation.
3. Ischemia: Refers to the reduced blood flow to the ovary due to torsion, which can lead to tissue death if not addressed promptly.
4. Surgical Emergency: Ovarian torsion is considered a surgical emergency, necessitating prompt diagnosis and intervention to preserve ovarian function.

Clinical Context

In clinical practice, it is essential to recognize the signs and symptoms of ovarian torsion, as timely intervention can prevent complications such as necrosis of the ovarian tissue. The condition is often diagnosed through imaging studies, such as ultrasound, which may reveal an enlarged, edematous ovary or the presence of free fluid in the pelvis.

Conclusion

Understanding the alternative names and related terms for ICD-10 code N83.51 is crucial for healthcare professionals involved in the diagnosis and treatment of this condition. Clear communication using these terms can facilitate better patient care and enhance the accuracy of medical records. If you have further questions or need additional information on this topic, feel free to ask!

The diagnosis of ICD-10 code N83.51, which refers to torsion of the ovary and ovarian pedicle, involves a combination of clinical evaluation, imaging studies, and specific diagnostic criteria. Below is a detailed overview of the criteria and considerations used in diagnosing this condition.

Clinical Presentation

Symptoms

Patients with ovarian torsion typically present with acute abdominal or pelvic pain. Key symptoms include:

• Sudden onset of unilateral pelvic pain: This is often severe and may be accompanied by nausea and vomiting.
• Abdominal tenderness: Physical examination may reveal tenderness in the lower abdomen, particularly on the affected side.
• Possible fever: In some cases, a low-grade fever may be present, indicating an inflammatory response.

Physical Examination

During the physical examination, healthcare providers look for:

• Adnexal tenderness: Tenderness upon palpation of the adnexa (the area adjacent to the uterus, including the ovaries and fallopian tubes).
• Cervical motion tenderness: This may also be assessed, although it is more commonly associated with other conditions like pelvic inflammatory disease.

Imaging Studies

Ultrasound

Transvaginal ultrasound is the primary imaging modality used to diagnose ovarian torsion. Key features that may indicate torsion include:

• Enlarged, edematous ovary: The affected ovary may appear enlarged and swollen.
• Absence of venous or arterial flow: Doppler ultrasound can assess blood flow; the absence of venous flow is particularly suggestive of torsion.
• Free fluid in the pelvis: This may be present due to associated hemorrhage or inflammation.

CT Scan

In some cases, a CT scan of the abdomen and pelvis may be utilized, especially if the diagnosis is uncertain or if there are concerns about other potential causes of abdominal pain. Findings may include:

• Enlarged ovary: Similar to ultrasound findings.
• Displacement of the ovary: The affected ovary may be displaced from its normal position.

Laboratory Tests

While laboratory tests are not definitive for diagnosing ovarian torsion, they can help rule out other conditions. Common tests include:

• Complete blood count (CBC): To check for signs of infection or inflammation, such as elevated white blood cell count.
• Pregnancy test: To rule out ectopic pregnancy, which can present similarly.

Differential Diagnosis

It is crucial to differentiate ovarian torsion from other conditions that can cause similar symptoms, such as:

• Ectopic pregnancy
• Ovarian cyst rupture
• Pelvic inflammatory disease
• Appendicitis

Conclusion

The diagnosis of ICD-10 code N83.51 for torsion of the ovary and ovarian pedicle relies on a combination of clinical symptoms, physical examination findings, and imaging studies, primarily ultrasound. Prompt diagnosis is critical, as timely intervention can prevent complications such as ovarian necrosis. If you suspect ovarian torsion, immediate medical evaluation is essential to ensure appropriate management and treatment.

Torsion of the ovary and ovarian pedicle, classified under ICD-10 code N83.51, is a critical gynecological emergency that requires prompt diagnosis and treatment to prevent complications such as loss of the affected ovary. Here’s a detailed overview of the standard treatment approaches for this condition.

Understanding Ovarian Torsion

Ovarian torsion occurs when the ovary twists around the ligaments that hold it in place, compromising its blood supply. This condition can lead to severe pain, nausea, and vomiting, and if not treated quickly, it can result in ovarian necrosis.

Diagnosis

Before treatment can begin, accurate diagnosis is essential. Common diagnostic methods include:

• Clinical Evaluation: Patients typically present with acute unilateral abdominal or pelvic pain, often accompanied by nausea and vomiting.
• Ultrasound: A pelvic ultrasound, particularly with Doppler studies, is the primary imaging modality used to assess blood flow to the ovary. It can help confirm the diagnosis by showing an enlarged, edematous ovary and the absence of venous or arterial flow.
• CT Scan: In some cases, a CT scan may be utilized to rule out other causes of acute abdominal pain, although it is less commonly used for this specific diagnosis.

Treatment Approaches

1. Surgical Intervention

The primary treatment for ovarian torsion is surgical intervention, which can be performed through:

• Laparoscopy: This minimally invasive technique is the preferred method for detorsion of the ovary. The surgeon makes small incisions in the abdomen and uses a camera to visualize the ovary. The twisted pedicle is untwisted, and the blood supply is restored. If the ovary is viable, it may be secured to prevent future torsion.
• Laparotomy: In cases where laparoscopy is not feasible or if there are complications (such as necrosis or rupture), a larger incision may be necessary to access the abdominal cavity.

2. Oophorectomy

If the ovary is found to be necrotic or severely damaged during surgery, an oophorectomy (removal of the affected ovary) may be necessary. This decision is made based on the viability of the tissue observed during the procedure.

3. Pain Management

Post-operative pain management is crucial. Patients may receive:

• Analgesics: Non-steroidal anti-inflammatory drugs (NSAIDs) or opioids may be prescribed to manage pain effectively.
• Antiemetics: Medications to control nausea and vomiting may also be administered.

4. Follow-Up Care

Post-operative follow-up is essential to monitor recovery and ensure no complications arise. Patients should be educated about signs of complications, such as increased pain, fever, or unusual discharge, which may indicate infection or other issues.

Conclusion

Ovarian torsion is a surgical emergency that necessitates prompt diagnosis and intervention to preserve ovarian function. The standard treatment involves laparoscopic detorsion, with the possibility of oophorectomy if the ovary is non-viable. Early recognition and treatment are critical to improving outcomes and minimizing complications associated with this condition. If you suspect ovarian torsion, immediate medical attention is crucial to ensure the best possible outcome.