ICD-10: N83.519

ICD-10 code N83.519 refers to the clinical condition known as "Torsion of ovary and ovarian pedicle, unspecified side." This 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.

Clinical Description

Definition

Ovarian torsion occurs when the ovary rotates around the ligaments that hold it in place, often involving the fallopian tube as well. This twisting can obstruct blood flow to the ovary, resulting in ischemia and, if untreated, can lead to tissue death. The condition is considered a surgical emergency due to the risk of losing the affected ovary.

Symptoms

Patients with ovarian torsion typically present with sudden onset abdominal or pelvic pain, which may be unilateral (affecting one side) but can also be bilateral. Other common symptoms include:
- Nausea and vomiting
- Abdominal tenderness
- Changes in bowel habits
- Fever (in some cases)

Diagnosis

Diagnosis of ovarian torsion is primarily clinical, supported by imaging studies. Common diagnostic tools include:
- Ultrasound: A pelvic ultrasound, particularly with Doppler studies, can help assess blood flow to the ovary and identify any cysts or masses.
- CT Scan: In some cases, a CT scan of the abdomen and pelvis may be utilized to provide a more comprehensive view of the pelvic organs.

Treatment

The standard treatment for ovarian torsion is surgical intervention, which may involve:
- Detorsion: Untwisting the affected ovary to restore blood flow.
- Oophorectomy: In cases where the ovary is necrotic or severely damaged, removal of the affected ovary may be necessary.
- Cystectomy: If an ovarian cyst is present, it may be removed during the procedure.

Coding Details

The code N83.519 is part of the ICD-10 classification system, specifically under the category of noninflammatory disorders of the ovary, fallopian tube, and broad ligament. The "unspecified side" designation indicates that the specific side of the torsion (right or left) is not documented or is not applicable in the clinical context.

Related Codes

• N83.51: Torsion of ovary and ovarian pedicle, right side
• N83.52: Torsion of ovary and ovarian pedicle, left side

Conclusion

Ovarian torsion is a critical condition that requires immediate medical attention to prevent irreversible damage to the ovary. The use of ICD-10 code N83.519 allows healthcare providers to accurately document and code this condition for billing and statistical purposes. Prompt diagnosis and surgical intervention are essential for optimal patient outcomes.

Torsion of the ovary and ovarian pedicle, classified under ICD-10 code N83.519, is a critical condition that requires prompt medical attention. Understanding its clinical presentation, signs, symptoms, and patient characteristics is essential for timely diagnosis and treatment.

Clinical Presentation

Ovarian torsion occurs when an ovary twists around the ligaments that hold it in place, compromising its blood supply. This condition can affect women of any age but is most commonly seen in those of reproductive age. The clinical presentation often includes acute abdominal or pelvic pain, which may be sudden in onset and severe.

Signs and Symptoms

1. Acute Pelvic Pain:
   - Patients typically report sudden, severe unilateral pelvic or abdominal pain. The pain may be sharp and can radiate to the lower back or thigh[1][2].

2. Nausea and Vomiting:
   - Accompanying symptoms often include nausea and vomiting, which may result from the pain or the body's response to the acute abdomen[1].

3. Abdominal Tenderness:
   - Physical examination usually reveals tenderness in the affected area, and there may be guarding or rebound tenderness, indicating peritoneal irritation[2].

4. Changes in Menstrual Cycle:
   - Some patients may experience changes in their menstrual cycle, such as amenorrhea or abnormal bleeding, particularly if the torsion is associated with an underlying ovarian cyst or mass[1].

5. Fever:
   - In some cases, a low-grade fever may be present, especially if there is associated inflammation or infection[2].

6. Urinary Symptoms:
   - Patients may also report urinary frequency or urgency, which can occur due to the proximity of the ovaries to the bladder[1].

Patient Characteristics

• Age:

• While torsion can occur at any age, it is most prevalent in women aged 20 to 40 years. It can also occur in prepubescent girls and postmenopausal women, although less frequently[1][2].

• Risk Factors:

• Certain factors may increase the risk of ovarian torsion, including:

  • Ovarian Cysts or Tumors: Larger cysts or masses can increase the likelihood of torsion due to their weight and mobility[1].
  • Previous Pelvic Surgery: Surgical history may alter the anatomy and increase the risk of torsion[2].
  • Hypermobile Ovaries: Some women may have anatomical variations that predispose them to torsion, such as a longer utero-ovarian ligament[1].

• Pregnancy:

• Torsion can occur during pregnancy, particularly in the first trimester, when the ovaries are enlarged due to hormonal changes[2].

Conclusion

Recognizing the clinical presentation, signs, symptoms, and patient characteristics associated with ICD-10 code N83.519 is crucial for healthcare providers. Early diagnosis and intervention are vital to prevent complications such as ovarian necrosis, which can occur if blood supply is not restored promptly. If a patient presents with acute pelvic pain, especially in the context of the aforementioned symptoms and risk factors, immediate evaluation and management are warranted to address the possibility of ovarian torsion.

The ICD-10 code N83.519 refers to "Torsion of ovary and ovarian pedicle, unspecified side." This condition occurs when an ovary twists around the ligaments that hold it in place, potentially compromising its blood supply and leading to severe complications if not treated promptly. Below are alternative names and related terms associated with this diagnosis.

Alternative Names

1. Ovarian Torsion: This is the most common term used to describe the condition, emphasizing the twisting of the ovary.
2. Adnexal Torsion: This term can refer to torsion of the ovary and the surrounding structures, including the fallopian tube.
3. Ovarian Pedicle Torsion: This highlights the involvement of the ovarian pedicle, which includes the blood vessels and ligaments attached to the ovary.

Related Terms

1. Acute Abdomen: Ovarian torsion can present as an acute abdomen, a medical emergency requiring immediate evaluation.
2. Pelvic Pain: Patients often experience significant pelvic pain, which is a common symptom associated with this condition.
3. Ischemia: Refers to the reduced blood flow to the ovary due to the torsion, which can lead to tissue death if not resolved.
4. Surgical Emergency: Ovarian torsion is considered a surgical emergency, necessitating prompt intervention to prevent complications.
5. Gynecological Emergency: This term encompasses conditions like ovarian torsion that require urgent care in the field of gynecology.

Clinical Context

Understanding these terms is crucial for healthcare professionals when diagnosing and treating patients with suspected ovarian torsion. The condition is often diagnosed through imaging studies, such as ultrasound, and may require surgical intervention to untwist the ovary and restore blood flow.

In summary, the ICD-10 code N83.519 is associated with several alternative names and related terms that reflect the clinical significance and urgency of the condition. Recognizing these terms can aid in effective communication among healthcare providers and enhance patient care.

The diagnosis of ovarian torsion, specifically coded as ICD-10 code N83.519 (Torsion of ovary and ovarian pedicle, unspecified side), involves a combination of clinical evaluation, imaging studies, and laboratory tests. Here’s a detailed overview of the criteria typically used for diagnosing this condition:

Clinical Presentation

Symptoms

Patients with ovarian torsion often present with acute abdominal or pelvic pain. Key symptoms include:
- Sudden onset of unilateral lower abdominal pain, which may be severe.
- Nausea and vomiting.
- Possible fever, although this is less common.
- Abdominal tenderness, particularly on the affected side.

Physical Examination

During a physical examination, healthcare providers may look for:
- Tenderness in the lower abdomen, especially on one side.
- Signs of peritoneal irritation, such as rebound tenderness.
- A palpable adnexal mass in some cases.

Imaging Studies

Ultrasound

Transvaginal ultrasound is the first-line imaging modality for suspected ovarian torsion. Key findings may include:
- Absence of venous or arterial flow to the affected ovary, which is indicative of torsion.
- Enlarged, edematous ovary.
- Presence of free fluid in the pelvis.

Doppler Studies

Doppler ultrasound can assess blood flow to the ovary. The absence of venous and/or arterial flow supports the diagnosis of torsion.

CT Scan

In some cases, a CT scan of the abdomen and pelvis may be performed to rule out other conditions, such as appendicitis or ectopic pregnancy. However, it is less commonly used for diagnosing ovarian torsion compared to ultrasound.

Laboratory Tests

While laboratory tests are not definitive for diagnosing ovarian torsion, they can help rule out other conditions:
- Complete blood count (CBC) may show leukocytosis if there is associated inflammation or infection.
- Urinalysis may be performed to exclude urinary tract infections or other renal issues.

Differential Diagnosis

It is crucial to differentiate ovarian torsion from other conditions that can present similarly, such as:
- Ectopic pregnancy.
- Ovarian cyst rupture.
- Appendicitis.
- Pelvic inflammatory disease (PID).

Conclusion

The diagnosis of ovarian torsion (ICD-10 code N83.519) relies heavily on clinical presentation, imaging studies, and the exclusion of other potential causes of acute abdominal pain. Prompt diagnosis and intervention are critical to prevent complications, such as loss of the affected ovary. If you suspect ovarian torsion, immediate medical evaluation is essential to ensure appropriate management.

When addressing the standard treatment approaches for the ICD-10 code N83.519, which refers to "Torsion of ovary and ovarian pedicle, unspecified side," it is essential to understand the condition's nature, symptoms, and the typical management strategies employed in clinical practice.

Understanding Ovarian Torsion

Ovarian torsion occurs when an ovary twists around the ligaments that hold it in place, potentially compromising its blood supply. This condition is considered a surgical emergency due to the risk of ischemia and necrosis of the affected ovary if not treated promptly. Symptoms often include sudden onset of severe pelvic pain, nausea, vomiting, and sometimes fever. Physical examination may reveal unilateral adnexal tenderness and a palpable adnexal mass.

Standard Treatment Approaches

1. Immediate Surgical Intervention

The primary treatment for ovarian torsion is surgical intervention, which is typically performed as an emergency procedure. The goals of surgery include:

• Detorsion: The first step is to untwist the affected ovary to restore blood flow. This is often done laparoscopically, which is less invasive and allows for quicker recovery.
• Oophorectomy or Salpingo-Oophorectomy: If the ovary is found to be necrotic or severely damaged, it may need to be removed (oophorectomy). In some cases, the fallopian tube may also be removed (salpingo-oophorectomy) if it is involved in the torsion or shows signs of damage.
• Fixation: To prevent recurrence, the surgeon may perform a procedure called oophoropexy, which involves securing the ovary to the pelvic sidewall.

2. Pain Management

Post-operative pain management is crucial. Patients may receive analgesics, including non-steroidal anti-inflammatory drugs (NSAIDs) or opioids, depending on the severity of pain and individual patient needs.

3. Monitoring and Follow-Up Care

After surgery, patients are monitored for complications such as infection or bleeding. Follow-up appointments are essential to ensure proper healing and to address any ongoing symptoms.

4. Consideration of Fertility

In cases where the patient is of childbearing age, preserving fertility is often a priority. Surgeons will aim to salvage the affected ovary whenever possible, especially if the torsion is diagnosed early and the ovary is still viable.

Conclusion

In summary, the standard treatment for ovarian torsion (ICD-10 code N83.519) primarily involves surgical intervention to detorse the ovary and restore blood flow, with additional steps taken to prevent recurrence and manage pain. Early diagnosis and prompt treatment are critical to preserving ovarian function and preventing complications. If you suspect ovarian torsion, it is vital to seek immediate medical attention to ensure the best possible outcome.