What is the immediate management for suspected ovarian torsion?

• A. Urgent surgical evaluation for detorsion or removal if necrotic.
• B. Observation with analgesia.
• C. Antibiotics.
• D. Hormonal therapy.

Answer: (A)

Ovarian torsion is a surgical emergency because twisting of the ovary and its vascular pedicle rapidly cuts off blood flow, risking ovary viability. The immediate management is urgent surgical evaluation with detorsion to restore perfusion and assess viability. If the ovary appears viable after detorsion, it is typically preserved; removal is reserved for nonviable, necrotic tissue. Delaying for observation or treating with antibiotics or hormonal therapy does not address the twisting or restore blood flow, and analgesia alone may delay diagnosis. While imaging can support suspicion, it should not delay operative exploration because time is critical to prevent irreversible tissue damage.