An ovarian torsion around a remnant of the urachus

We report a case of ovarian torsion around a remnant of the urachus. Though it usually develops into the median umbilical ligament, abnormalities in urachal development can occur which can lead to remnants being present in the adult abdomen. This case describes a young female who had intermittent lower abdominal pain over a period of three weeks. During this period several ultrasound scans were performed which reported different anatomy and possible causes of the pain. Only on diagnostic laparoscopy and confirmed via histology, was it found that she had experienced ovarian torsion around an urachal remnant. Unfortunately due to the delay from symptom onset to her operation, her ovary was not salvageable. This case highlights the variability of ultrasound findings and demonstrates how a remnant can contribute to ovarian torsion and subsequent infarction.