The ovarian ligament (proper ligament of the ovary) is a smooth muscle and fibrous cord connecting the medial ovarian pole to the uterine body. It is the remnant of the inferior part of the gubernaculum. Together with the infundibulopelvic ligament (suspensory ligament of the ovary) laterally, it tethers the ovary in position. Ovarian torsion occurs when the ovary twists on these ligaments, compromising its blood supply.
| Origin | Medial pole of the ovary |
|---|---|
| Insertion | Posterolateral uterine wall below the fallopian tube insertion |
| Actions | Connects the ovary to the uterus; tethers the ovary in the pelvic cavity |
|---|
Ovarian torsion presents as sudden unilateral pelvic pain and is a gynaecological emergency requiring laparoscopic de-torsion within hours to preserve ovarian viability. The ovary twists around the ovarian ligament and the infundibulopelvic ligament, compromising the ovarian artery and vein. Early de-torsion even of a necrotic-appearing ovary preserves fertility in most cases.
Ovary twisting on its ligamentous attachments producing acute pelvic pain and ovarian ischaemia requiring emergency laparoscopic de-torsion.
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