scholarly journals Rare case of torsion of giant ovarian mass post-colonoscopy

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Irene A T Ng ◽  
Jolene S M Wong ◽  
Jermaine Wong ◽  
Claramae S Chia ◽  
Chin-Ann J Ong
Keyword(s):  
Abdominal Pain ◽  
Ovarian Cyst ◽  
Frozen Section ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Serous Cystadenoma ◽  
Ovarian Torsion ◽  
Ovarian Mass ◽  
Large Ovarian Cyst ◽  
The Right

ABSTRACT We present an unprecedented case of torsion of a large ovarian cyst following colonoscopy. A 43-year-old female was found to have a 20 × 13 × 19 cm pelviabdominal mass possibly arising from the right ovary. Endoscopic evaluation was performed prior to planned resection of the ovarian mass. The patient experienced progressive lower abdominal pain after the procedure with a computed topography finding of torsion. She underwent exploratory laparotomy, right salpingo-oophorectomy with intra-operative frozen section and omentectomy. Final histology revealed features of benign serous cystadenoma with extensive haemorrhagic infarction in keeping with torsion. To our knowledge, this is the first reported case of torsion of a large ovarian cyst after colonoscopy. We propose a postulated mechanism of this patient’s ovarian torsion and urge clinicians to be cognizant of acute ovarian torsion as a cause of severe abdominal pain following endoscopy.

scholarly journals Huge Ovarian Cyst- A Case Report

2020 ◽  
Vol 2 (2) ◽  
pp. 87-90
Author(s):  
Sunita Maharjan ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Ovarian Cyst ◽  
Ovarian Tissue ◽  
Delayed Diagnosis ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Ultrasound Finding ◽  
Emergency Laparotomy ◽  
Diagnosis And Management ◽  
The Right

Ovarian cyst torsion (also termed as adnexal torsion) refers to partial or complete rotation of the ovary and a portion of fallopian tube along with its supply to vascular pedicle. It occurs commonly in females of all age group, more on the right side (60%) and often with acute lower abdominal pain lasting for few hours up to 24 hours. Ovarian cyst torsion is one of the devastating conditions hampering blood supply of ovary which may lead to total necrosis of ovarian tissue like in our case. Delayed diagnosis and management can lead to various complications. Here, we present a case of 46 years old perimenopausal female, para 2, living 2 who presented to our emergency department with complain of sudden onset severe pain abdomen since morning. Emergency exploratory laparotomy was done due to high clinical suspicion of torsion based on previous ultrasound finding of ovarian cyst done a day prior to the presentation. On intraoperative finding, the cyst was already necrosed. Due to timely diagnosis and management by emergency laparotomy, anticipated complications were reduced.    

scholarly journals Legal Implication of Ovarian Cysts in Prepuberal Girl

2020 ◽  
Vol 5 (7) ◽  
Keyword(s):  
Ovarian Cyst ◽  
Ovarian Function ◽  
Clinical Course ◽  
Lower Abdominal Pain ◽  
Ovarian Torsion ◽  
Ovarian Cysts ◽  
Legal Implications ◽  
Extra Weight ◽  
The Right ◽  
Legal Implication

Ovarian torsion is a condition that can occur in a normal ovary, but it is more likely to happen when the presence of a cyst or other tissues (tumor) in the ovary can displace it. The extra weight or mass on the ovary can cause it to start to twist and rotate around its supporting ligaments. Ovarian torsion can cause severe pain, more frequently on the right-hand side. However, in some cases, the clinical course is prolonged, as the torsion can be intermittent. Early diagnosis and surgery are essential to protect ovarian and tubal function and prevent severe morbidity ending with annessiectomy. The ovarian cyst is an insidious risk factor for ovarian torsion and can cause sudden lower abdominal pain and loss of ovarian function with possible legal implications and malpractice. A timely diagnosis of ovarian cyst is of paramount importance to prevent necrosis and preserve ovarian viability. To avoid such a dangerous complication, it is essential the preventive management of the cyst. A cyst becomes a problem when it does not go away or gets bigger. The treatment of ovarian cysts depends on several factors but the size of the cyst and its appearance need to be monitored.

scholarly journals Pediatric Ovarian Torsion: A Diagnostic Challenge in COVID-19 Times

2020 ◽  
Vol 18 (2) ◽  
pp. 120-123
Author(s):  
R. Chanchlani ◽  
M. Jangid ◽  
R. Ahmad ◽  
P. Sharma
Keyword(s):  
Abdominal Pain ◽  
Surgical Intervention ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
Ovarian Torsion ◽  
Diagnosis And Treatment ◽  
Diagnostic Challenge ◽  
Delay In Diagnosis ◽  
Functional Loss ◽  
Early Surgical Intervention

Ovarian torsion is a rare gynecological emergency in children and an early surgical intervention is needed to salvage the ovary. Herein, we present a case of eight year old girl who presented with complaints of lower abdominal pain during ongoing COVID-19 pandemic. She was diagnosed as a case of ovarian torsion on right side. She underwent exploratory laparotomy and ovarian cystectomy was performed. Delay in diagnosis and treatment of ovarian torsion may have grave consequences, resulting in functional loss of the ovary.

scholarly journals Huge hemorrhagic ovarian cyst alongside suspected ovarian torsion: a case report

2020 ◽  
Vol 7 (2) ◽  
pp. 91-94
Author(s):  
Namita Sindan ◽  
Adheesh Bhandari
Keyword(s):  
Ovarian Cyst ◽  
Ovarian Tissue ◽  
Lower Abdominal Pain ◽  
Ovarian Torsion ◽  
Reproductive Age ◽  
Ovarian Cysts ◽  
Gynecology And Obstetrics ◽  
The Right ◽  
Reproductive Age Group

An ovarian cyst is usually a relatively large, fluid-filled cystic structure (diameter greater than 3 cm) that originates from the surface or inside the ovary. Ovarian cysts can be simple or complex, depending on their internal material. Hemorrhagic ovarian cysts (HOCs) are commonly seen in clinical practice. Most of them resolve naturally during follow-up except in a minority of cases in which surgical intervention is needed. Ovarian torsion indicates partial or complete rotation of the ovary and a portion of the fallopian tube along its supplying vascular pedicle. It usually occurs in the reproductive age group, more on the right side (about 60%), and often presents with acute lower abdominal pain lasting for a few hours to 24 hours. It is one of the harmful conditions, hampering blood supply of ovary which may rise to overall necrosis of ovarian tissue and other difficulties, if not identified and managed in time. We present a case of a huge hemorrhagic ovarian cyst managed in the Department of Gynecology and Obstetrics, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal.

HETEROTOPIC PREGNANCY WITH INEVITABLE ABORTION (RIGHT ADNEXAL LIVE ECTOPIC AND COEXISTING INTRAUTERINE TRIPLETS WITH ABSENT FETAL CARDIAC ACTIVITY)

2021 ◽  
pp. 58-59
Author(s):  
Jayanta Sarkar ◽  
Mini Sengupta
Keyword(s):  
Ectopic Pregnancy ◽  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
Cardiac Activity ◽  
Exploratory Laparotomy ◽  
Sudden Onset ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Short Period ◽  
The Right

Heterotopic pregnancy describes the occurrence of two or more pregnancies in different implantation sites simultaneously, intrauterine pregnancy coexists withectopic pregnancies (ampullary in 80%). A 27-year-old women (P ,L1) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain with 1+1 vaginal bleeding and had a short period of Amenorrhea. Ultrasonography demonstrated three intrauterine gestational sacwith foetal pole noted but Cardiac activity was absent . The right adnexa showed a heteroechoic area andmoderate amount of free uid was present in the lower abdominal cavity. Ectopic pregnancy was disturbed. An emergency exploratory laparotomy was performed under general anesthesia. Haemoperitoneum was found with a ruptured righttubal ectopic pregnancy as well. Both the ovaries appeared normaland a corpus luteal cyst was presentin right ovary. Right sided salpingectomy was performed with removal of the ectopic mass,heamostasis secured ,on table blood transfusion had been given.Suction evacuation had also been performed by manual vacuum aspirationon same sitting.Both the specimen send for histopathology. Histology conrmedGestational sac suggestive of an intra uterine pregnancy coexists with ectopic pregnancy. Left tube and both ovaries were found healthy. Episodes of PID also have a strong correlation with occurrence of ectopic gestation. Once diagnosis of heterotrophic pregnancy has been made the management is essentially surgical.

scholarly journals Thrombophlebitis of the Right Renal Capsular Vein during the Early Postpartum Period

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Koji Nakamura ◽  
Kensuke Nakanishi ◽  
Satoshi Kubota ◽  
Ryoko Takahashi ◽  
Mari Tomiie ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Postpartum Period ◽  
Anticoagulation Therapy ◽  
Lower Abdominal Pain ◽  
Postpartum Woman ◽  
Ovarian Vein ◽  
Early Postpartum Period ◽  
Early Postpartum ◽  
The Right ◽  
Contrast Ct

Venous thrombophlebitis is an uncommon cause of fever and lower abdominal pain during the early postpartum period. It mostly occurs in the right ovarian vein, and computed tomography (CT) is useful for diagnosis. We present a case of thrombophlebitis of the renal capsular vein. A 27-year-old postpartum woman presented with right lower abdominal pain and fever unresponsive to antibiotics. Contrast CT showed a ring-enhancing mass in the right retroperitoneum, which was distinct from the right ovarian vein. Exploratory laparoscopy revealed a retroperitoneal hematoma and normal appendix. Reconstruction of CT images revealed that the mass was connected to the right renal capsular vein. Anticoagulation therapy improved the patient’s symptoms. Postpartum thrombophlebitis can occur at locations other than the ovarian vein, such as the renal capsular vein. If a retroperitoneal mass is discovered during puerperium, a thorough investigation of the mass’s continuity with surrounding vessels is essential to avoid unnecessary surgery.

scholarly journals A Case of Ovarian Torsion Which Led to Abortion

2021 ◽  
Author(s):  
Athar Rasekhjahromi ◽  
Sahand Goodarzi ◽  
Navid Kalani
Keyword(s):  
Blood Flow ◽  
Abdominal Pain ◽  
Color Doppler ◽  
Ovarian Torsion ◽  
Simultaneous Occurrence ◽  
Pelvic Ultrasound ◽  
Triplet Pregnancy ◽  
Vaginal Pain ◽  
History Of ◽  
The Right

Ovarian torsion occurs in 10%-22% of pregnant women, and miscarriage occurs in 11%-22% of all pregnancies, both of which are known as gynecological emergencies. The simultaneous occurrence of these two cases is rare. The present study reports a case of ovarian torsion and simultaneous abortion. In this case report, we present a 28-year-old woman in her third pregnancy with a history of two miscarriages. She was referred with an 18-week triplet pregnancy, vaginal pain and bleeding from the previous day, and colic abdominal pain with five episodes of nausea and vomiting. Upon admission to the hospital, despite performing cerclage at 13 weeks, labor pains begin, and 15 minutes later, the amniotic sac ruptures, and all three fetuses are expelled. Due to the persistence of colic pain and moderate tenderness in the lower right quadrant of the abdomen, pelvic ultrasound is reported, which shows an increase in echo parenchyma and the size of the right ovary compared to the left ovary. Doppler ultrasound showed decreased ovarian blood flow, which led to laparotomy with suspected ovarian torsion. The right ovarian peduncle had complete torsion, and the ovary appeared dark. The peduncle of ovarian torsion was opened and preserved. The patient was discharged two days after surgery and after re-color Doppler ultrasounds, which indicated ovarian blood flow.

Ileoscopy in the Diagnosis of lleal Lymphosarcoma

PEDIATRICS ◽  
1975 ◽  
Vol 56 (1) ◽  
pp. 127-129
Author(s):  
Seymour Katz ◽  
Irwin Katzka ◽  
Keith Schneider ◽  
Mervin Silverberg
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Gastrointestinal Tract ◽  
Inflammatory Process ◽  
Lower Abdominal Pain ◽  
Recurrent Abdominal Pain ◽  
Neoplastic Disease ◽  
Direct Visualization ◽  
Appendiceal Abscess ◽  
The Right

Recent advances in flexible fiberoptic endoscopy have permitted direct visualization of segments of the gastrointestinal tract hitherto considered inaccessible. Preoperative diagnoses of diseases of these areas are subject to the vagaries of roentgen interpretation. The following case report illustrates the value of the colonoscope in distinguishing intralumenal ileal neoplastic disease from an inflammatory process (e.g., ileitis, appendiceal abscess). CASE REPORT W. M., a 15-year-old white youth, was referred for eveluation of intermittent lower abdominal pain of six weeks' duration. Prior to his admission, he experienced cramping abdominal pain, fever, cough, emesis, and diarrhea. This gradually abated, leaving a residuum of recurrent abdominal pain which was relieved partially with fiexion of the right thigh.

Torsion of a parasitic leiomyoma: a rare but important differential in women presenting with lower abdominal pain

2021 ◽  
Vol 14 (1) ◽  
pp. e232797
Author(s):  
Clemmie Stebbings ◽  
Ahmed Latif ◽  
Janakan Gnananandan
Keyword(s):  
Abdominal Pain ◽  
Iliac Fossa ◽  
Lower Abdominal Pain ◽  
Sudden Onset ◽  
Greater Omentum ◽  
Caribbean Woman ◽  
History Of ◽  
Right Iliac Fossa Pain ◽  
The Right ◽  
Fat Stranding

A 39-year-old multiparous Afro-Caribbean woman attended the emergency department with sudden-onset severe right iliac fossa pain. Her inflammatory markers were mildly elevated. Computerised tomography of the abdomen demonstrated features of fat stranding in the right iliac fossa suspicious of acute appendicitis. The scan also noted uterine leiomyomas. The patient was taken to theatre for an emergency diagnostic laparoscopy where her appendix was found to be macroscopically normal. A necrotic heavily calcified parasitic leiomyoma was seen in the right adnexa, free of the uterus and adherent to the greater omentum on a long torted pedicle. The parasitic leiomyoma was successfully removed piecemeal laparoscopically. Complications of leiomyomas, namely, torsion and necrosis, are important differentials in women presenting with sudden-onset lower abdominal pain. A history of sudden-onset severe lower abdominal pain with a background of known leiomyoma should prompt the clerking surgeon to consider a complication of leiomyoma as part of the differential diagnoses.

scholarly journals The real cause of right lower abdominal pain: an analysis of ultrasonographic findings

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094618
Author(s):  
Xia Zhang ◽  
Biaohu Liu ◽  
Xiangming Zhu ◽  
Guobing Hu
Keyword(s):  
Abdominal Pain ◽  
Histopathological Examination ◽  
Splenic Vein ◽  
Lower Abdominal Pain ◽  
Accessory Spleen ◽  
Large Mass ◽  
Splenic Tissue ◽  
Common Disease ◽  
Ureteral Calculus ◽  
The Right

A pelvic accessory spleen is uncommon and most patients with this condition are asymptomatic. Ureteral calculus is a common disease and can cause acute abdominal pain. We report a 51‐year‐old male patient who presented at our hospital with acute right lower abdominal pain and gross hematuria. A large mass on the right side of the pelvis was detected on an ultrasound examination, as well as a calculus in the lower segment of the right ureter. Computed tomography angiography showed the presence of a long vascular pedicle with an artery originating from the splenic artery and a vein that joined with the splenic vein. Laparoscopy was carried out and it showed a solid mass covered with omentum on the right lower abdomen. The mass was then removed surgically. Histopathological examination of the resected specimens confirmed splenic tissue. We speculate that the accessory spleen and ureteral calculus caused right lower abdominal pain in our case. However, the ureteral calculus might have played a much more important role in causing acute right lower abdominal pain than the accessory spleen.

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