[2] Patients with ovarian torsion often present with sudden onset of sharp and usually unilateral lower abdominal pain, in 70% of cases accompanied by nausea and vomiting.

In the reproductive years, regular growth of large corpus luteal cysts are a risk factor for rotation.

Torsion of the ovary usually occurs with torsion of the fallopian tube as well on their shared vascular pedicle around the broad ligament, although in rare cases the ovary rotates around the mesovarium or the fallopian tube rotates around the mesosalpinx.

[citation needed] Ovarian torsion is difficult to diagnose accurately, and operation is often performed before certain diagnosis is made.

A study at an obstetrics and gynaecology department found that preoperative diagnosis of ovarian torsion was confirmed in only 46% of people.

[9][10] However, doppler flow is not always absent in torsion – the definitive diagnosis is often made in the operating room.

[7] Specific flow features on Doppler sonography include:[8] Normal vascularity does not exclude intermittent torsion.