Ovarian Torsion on CT: The Whirl Sign You Don't Want to Miss

A twisted vascular pedicle ('whirl sign') on CT is the hallmark of ovarian torsion, a surgical emergency. This case showed a large cystic adnexal mass with four twists around its pedicle, resulting in infarction. Ovarian masses >5 cm greatly increase torsion risk.

• An adnexal cystic mass >5 cm with a twisted vascular pedicle should immediately raise concern for ovarian torsion.
• At surgery, the ovary was twisted four times and infarcted, underscoring the urgency of CT recognition.
• Greater mass size (>5 cm) significantly increases torsion risk, making the whirl sign critical to detect.

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