Simultaneous Bilateral Ovarian Torsion in a Transgender Patient

Ovarian torsions are a diagnostic challenge in the emergency room that result in significant morbidity when missed. Ovarian torsions have a low incidence and can present with atypical and variable symptoms. As such, recognition of ovarian torsion is a key skill that emergency clinicians must master. Typically, ovarian torsion is a unilateral finding but there have been cases of bilateral torsions noted previously in the literature. These rare cases tend to have higher morbidity making it even more important to recognize. This case is unique in that it was a transgendered patient developing synchronous bilateral ovarian torsions, which, to our knowledge, has not been previously described in the literature. This case illustrates the potential for unique presentations of this condition. We advise a high index of suspicion until more data, both objective and subjective gestalt, is known.