scholarly journals Herniation of Small Bowel Loop through a Broad Ligament Defect Masquerading as Torsion of Ovarian Cyst

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Babatola Bakare ◽  
Olumide Akadiri ◽  
Akinyemi Akinsoji Akintayo
Keyword(s):  
Abdominal Pain ◽  
Abdominal Surgery ◽  
Acute Abdomen ◽  
Ovarian Cyst ◽  
Broad Ligament ◽  
Previous History ◽  
Lower Abdominal Pain ◽  
Reproductive Age ◽  
Essentially Normal ◽  
Broad Ligament Defect

Torsion of ovarian cyst is a common cause of acute abdomen especially in women of reproductive age-group. It commonly presents with colicky abdominal pain associated with nausea and vomiting. It could however mimic acute intestinal obstruction. The patient was a 32-year-old multipara with no previous history of pelvic or abdominal surgery. She was admitted with colicky lower abdominal pain associated with repeated episodes of vomiting and nausea. Laboratory investigations were essentially normal. Abdominopelvic USS showed a hypoechoic mass lesion in the left adnexium measuring 7.1 × 5.5 cm; surrounding bowel loops were hypoactive, dilated, and fluid filled. Diagnosis of acute abdomen secondary to suspected torsion of ovarian cyst was made. Management began for acute abdomen with intravenous hydration, prophylactic antibiotics, and analgesics. An emergency laparotomy revealed about 6 cm defect in the left broad ligament in which a 20 cm segment of terminal ileum was encased. Liberation of the ileal segment was done and the broad ligament defect closed. Bowel obstruction requires high index of suspicion in a patient with acute abdomen due to suspected torsion ovarian cyst most especially in the absence of previous pelvic or abdominal surgery.

scholarly journals Management of hemoperitoneum due to rupture of the ovarian cyst

2021 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Oana Denisa Balalau ◽  
Ileana Maria Conea ◽  
Nicolae Bacalbasa ◽  
Anca Silvia Dumitriu ◽  
Stana Paunica ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ovarian Cyst ◽  
Lower Abdominal Pain ◽  
Physical Exertion ◽  
Sudden Onset ◽  
Reproductive Age ◽  
Adnexal Torsion ◽  
Ultrasound Monitoring ◽  
Chemical Peritonitis ◽  
Rule Out

Ovarian cyst is the most common female gynecological pathology and it is characteristic of reproductive age. Its rupture causes the sudden onset of pelvic-abdominal pain, often associated with physical exertion or sexual contact. The differential diagnosis is made with other causes of lower abdominal pain: ectopic pregnancy, adnexal torsion, pelvic inflammatory disease or acute appendicitis. The clinical picture may vary depending on the type of ruptured cyst. Dermoid cyst causes severe symptoms due to chemical peritonitis that occurs in response to extravasation of sebaceous contents in the peritoneal cavity. Surgical treatment is indicated for complicated forms of cystic rupture. Most cases have self-limiting, quantitatively reduced bleeding and spontaneous resorption within a few days. Patients diagnosed with ovarian cyst are recommended for regular ultrasound monitoring to prevent complications such as cystic rupture or adnexal torsion. The identification of any ovarian tumor mass in the woman at menopause requires further investigation to rule out the causes of malignancy.

scholarly journals Isolated twisted hematosalphinx misleading with ovarian cyst torsion

2019 ◽  
Vol 8 (3) ◽  
pp. 1219
Author(s):  
Vaibhav Khairnar ◽  
Shalini Mahana Valecha ◽  
Pandeeswari .
Keyword(s):  
Acute Abdomen ◽  
Fallopian Tube ◽  
Ovarian Cyst ◽  
Rare Case ◽  
Delayed Diagnosis ◽  
Lower Abdominal Pain ◽  
Clinical Findings ◽  
Reproductive Age ◽  
High Risk Factors ◽  
Acute Pelvic Pain

Normal or chronically inflamed fallopian tube can undergo torsion and present as acute abdomen, simulating clinically as ectopic gestation. Torsion of the fallopian tube is less frequent but significant cause of lower abdominal pain in reproductive age women that is difficult to recognize preoperatively. Authors present a rare case of hematosalpinx with torsion at its pedicle with hemoperitonium who presented as 28 years old female with acute abdomen that was successfully treated. In cases presenting with hemoperitoneum diagnosis of ruptured ectopic pregnancy should be made unless proved otherwise during reproductive age. Rarely ruptured ovarian cyst may also be a cause. Unfortunately, hematosalpinx sometimes can undergo torsion due to circulatory imbalance and can present as hemoperitoneum and circulatory collapse due to rupture. There have been no specific symptoms, clinical findings, imaging or laboratory characteristics identified for this condition. Imaging findings are non-specific in the preoperative diagnosis of torsed fallopian tubes. Therefore, most of cases with isolated fallopian tubal torsion had a delayed diagnosis and a subsequent delay of timely intervention that may result in failure to save tubal function. Torsion of tube can lead to hematosalpinx, hemoperitonium and necrosis of tube which necessitates urgent surgical management. This case report describes a twisted hematosalpinx presentation without any predisposing high-risk factors. A tubal torsion should be suspected in females with acute pelvic pain, of any age group. An early diagnosis and treatment are required to prevent complications. This rare case may highlight a new insight into pathogenesis of tubal torsion associated with hematosalpinx.

scholarly journals Didelphys uterus: misleading as ovarian cyst

2013 ◽  
Vol 45 (1-2) ◽  
pp. 30-32
Author(s):  
Shamsun Nahar ◽  
Bishwajit Das ◽  
Ferdowsi Begum
Keyword(s):  
Abdominal Pain ◽  
Abdominal Surgery ◽  
Female Patient ◽  
Young Adulthood ◽  
Ovarian Cyst ◽  
Lower Abdominal Pain ◽  
Primary Amenorrhoea ◽  
History Of ◽  
Delayed Menarche ◽  
Unmarried Girl

Mullerian duct anomalies are not uncommon. Anomalies may be diagnosed in infancy, adolescene or young adulthood. Female patient may present with a mass resulting from mucocolpos, haematocolpos, haematometra or primary amenorrhoea, delayed menarche, infertility and repeated pregnancy loses. A 14 years unmarried girl came with lower abdominal pain and mass with severe dysmenorrhoea with a history of lower abdominal surgery 5 months back. Clinically it was diagnosed as ovarian cyst but after laparotomy it was detected didelphys uterus. Left uterus was non-communicated with vagina forming haematometra. Right uterus well developed with one tube and healthy ovary. DOI: http://dx.doi.org/10.3329/bmjk.v45i1-2.13627 Bang Med J (Khulna) 2012; 45 : 30-32

scholarly journals Abdominal wall endometriosis: experience of the General Surgery Service of the Antônio Pedro University Hospital of the Universidade Federal Fluminense

2020 ◽  
Vol 47 ◽  
Author(s):  
JORGE EDUARDO FARIA ROCHA COSTA ◽  
ITALO ACCETTA ◽  
FRANCISCO JOSÉ SANTOS MAIA ◽  
RENATO AUGUSTO MOREIRA DE SÁ
Keyword(s):  
Cesarean Section ◽  
Abdominal Surgery ◽  
Abdominal Wall ◽  
General Surgery ◽  
Previous History ◽  
Reproductive Age ◽  
University Hospital ◽  
Significance Level ◽  
Abdominal Wall Endometriosis ◽  
Previous Cesarean

ABSTRACT Objective: to study the characteristics of women undergoing abdominal surgery with suspected abdominal wall endometriosis or abdominal wall tumor, and to assess the association with age, race and previous cesarean delivery. Method: retrospective and analytical study carried out from January 2000 to December 2019, at the General Surgery Service of Hospital Universitário Antônio Pedro (HUAP) at Universidade Federal Fluminense (UFF). Medical records of 100 patients with abdominal wall endometriosis and other types of abdominal wall tumors were analyzed. Age, color, previous history of cesarean section or abdominal surgery and histopathological data were verified. The patients were classified as young adults (aged between 18 and 28 years and 11 months) and adults. The SPSS program was used for data analysis, Fisher’s test with a significance level of 0.05. Results: abdominal wall endometriosis with histopathological confirmation was found in 22%, the mean age was 52.28 ± 18.66 which was lower when compared to other diagnoses. There was an association between previous cesarean section and abdominal wall endometriosis (p <0.005). Conclusion: the women with a diagnosis of abdominal wall endometriosis had undergone previous cesareans (the majority) and were in an active reproductive age. Although the brown skin women were the most frequent, there was no statistical difference.

scholarly journals Clinical microbiological case: right lower abdominal pain progressing to acute abdomen

2002 ◽  
Vol 8 (2) ◽  
pp. 130-131
Author(s):  
J. Fyjoo Casero ◽  
K.L. Enguez ◽  
T.W. Jorgensen ◽  
F.J.P. Rodríguez
Keyword(s):  
Abdominal Pain ◽  
Acute Abdomen ◽  
Lower Abdominal Pain

scholarly journals Dysgerminoma: diagnostic impasse

2020 ◽  
Vol 7 (11) ◽  
pp. 3811
Author(s):  
Indrajit Anandakannan ◽  
Shanthi Ponnandai Swaminathan ◽  
Vikas Kawarat ◽  
Rajeshwari Mani ◽  
Kannan R.
Keyword(s):  
Abdominal Pain ◽  
Abdominal Mass ◽  
Germ Cell Tumour ◽  
Lower Abdominal Pain ◽  
Gastrointestinal Stromal Tumour ◽  
Reproductive Age ◽  
Ca 125 ◽  
Abdominal Radiograph ◽  
Bowel Loop ◽  
Plain Abdominal Radiograph

Dysgerminoma is a rare malignant ovarian tumour in women of reproductive age group, featuring lower abdominal pain and abdominal mass with elevated tumour markers. The tumour grows rapidly and diagnosed at an earlier stage. We present a short-statured 20 years girl with intermittent abdominal pain and distention for 4 months, on examination huge abdominal mass of size 20x15 cm, firm in consistency was palpable, lower limit not ascertained. Routine blood investigations normal, thyroid function test showed hypothyroidism. A plain abdominal radiograph shows a large homogenous mass fitting mid part of abdomen with displaced bowel loop. Contrast-enhanced computed tomography abdomen and pelvis show up 20x18.5x9.5 cm well defined heterogeneous mass, with areas of necrosis suggesting mesenchymal tumour or germ cell tumour. CA 125, alpha-fetoprotein, lactate dehydrogenase, beta human chorionic gonadotropin were raised. Magnetic resonance imaging abdomen and pelvis show 10x16x17cm hetero intense lesion, bilateral ovary normal. After tumour board discussion image-guided biopsy was done, suggestive of epithelioid gastrointestinal stromal tumour. Laparotomy displayed a large mass 22x16x10 cm arising from left ovary, no enlarged lymph node, completed with left salpingo-oophorectomy. Histopathology examination and immunohistochemistry definitive of dysgerminoma. In this clinical scenario, we narrate the importance of clinical examination and increased dependence on imaging modalities in diagnosing the patient. The treatment is based on the international federation of gynaecology and obstetrics staging with surgical treatment, adjuvant chemotherapy and radiotherapy.

scholarly journals A Case of Isolated Cecal Necrosis Preoperatively Diagnosed with Perforation of Cecum

Medicina ◽  
2019 ◽  
Vol 55 (1) ◽  
pp. 9 ◽  
Author(s):  
Atsushi Kohga ◽  
Kiyoshige Yajima ◽  
Takuya Okumura ◽  
Kimihiro Yamashita ◽  
Jun Isogaki ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Preoperative Diagnosis ◽  
Previous History ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Ileocecal Resection ◽  
Urgent Surgery ◽  
Ischemic Change ◽  
History Of ◽  
Laparoscopic Assisted

Isolated cecal necrosis (ICN) is a rare condition which is developed under decreased mesenteric perfusion. Only a few dozen cases of ICN have been reported previously. The patient was a 59-year-old male with a previous history of atrial fibrillation. He presented to our emergency room with the chief complaint of lower abdominal pain. Computed tomography imaging revealed a dilated cecum and presence of free air. With a preoperative diagnosis of perforation of the cecum; an urgent surgery was conducted. Intraoperative findings revealed an ischemic change of the cecum and a laparoscopic-assisted ileocecal resection was performed. The pathological findings showed transmural ischemic change on the anti-mesenteric side of the cecum, and the diagnosis of ICN was achieved. Preoperative diagnosis of ICN is difficult because of its non-specific radiological features. In patients with right lower abdominal pain, ICN should be considered as a differential diagnosis especially if the patient has a comorbidity causing hypotension attack.

scholarly journals Validation of the Diagnostic Score for Acute Lower Abdominal Pain in Women of Reproductive Age

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Kijja Jearwattanakanok ◽  
Sirikan Yamada ◽  
Watcharin Suntornlimsiri ◽  
Waratsuda Smuthtai ◽  
Jayanton Patumanond
Keyword(s):  
Abdominal Pain ◽  
Likelihood Ratio ◽  
Lower Abdominal Pain ◽  
Positive Likelihood Ratio ◽  
Clinical Score ◽  
Reproductive Age ◽  
Differential Diagnoses ◽  
Validation Data ◽  
Diagnostic Score ◽  
Development Data

Background. The differential diagnoses of acute appendicitis obstetrics, and gynecological conditions (OB-GYNc) or nonspecific abdominal pain in young adult females with lower abdominal pain are clinically challenging. The present study aimed to validate the recently developed clinical score for the diagnosis of acute lower abdominal pain in female of reproductive age.Method. Medical records of reproductive age women (15–50 years) who were admitted for acute lower abdominal pain were collected. Validation data were obtained from patients admitted during a different period from the development data.Result. There were 302 patients in the validation cohort. For appendicitis, the score had a sensitivity of 91.9%, a specificity of 79.0%, and a positive likelihood ratio of 4.39. The sensitivity, specificity, and positive likelihood ratio in diagnosis of OB-GYNc were 73.0%, 91.6%, and 8.73, respectively. The areas under the receiver operating curves (ROC), the positive likelihood ratios, for appendicitis and OB-GYNc in the validation data were not significantly different from the development data, implying similar performances.Conclusion. The clinical score developed for the diagnosis of acute lower abdominal pain in female of reproductive age may be applied to guide differential diagnoses in these patients.

scholarly journals Epidemiology and Risk Factors of Pelvic Inflammatory Disease.

2015 ◽  
Vol 13 (1) ◽  
pp. 4-8
Author(s):  
Bandana Pandey
Keyword(s):  
Abdominal Pain ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Rural Areas ◽  
Lower Abdominal Pain ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Age Group ◽  
Increased Risk ◽  
Reproductive Age Group

Introduction: Knowledge of pelvic inflammatory disease and its epidemiology is essential to understand reproductive morbidity in women. This paper estimates the level of association between demographic factors and pelvic inflammatory disease in women in their reproductive age. Methods: A descriptive study done in Humla, Kritipur and Baudha by organizing a health camp. Women of reproductive age group and who have lower abdominal pain, pervaginal discharge, fever, and dysparunia were included in the study after taking informed verbal consent from the patient. Patients who have lower abdominal pain and pervaginal discharge were diagnosed as pelvic inflammatory disease. Results: Diagnoses of pelvic inflammatory disease were made in 30% of attendances amongst women aged between 16 to 48. Increased risk of pelvic inflammatory disease was associated with smoking (P<0.0001), age groups 31 – 40 yrs (44.6%),in rural areas(45%) and people who are illiterate (P<0.0001). Among 400, 383(95%) were reported ever using a modern contraceptive. Conclusion: The prevalence of pelvic inflammatory disease was 30% in reproductive age group and was significantly associated with smoking.doi: http://dx.doi.org/10.3126/mjsbh.v13i1.12992 

scholarly journals Experience with Ectopic Pregnancy in a Tertiary Care Teaching Hospital

2018 ◽  
Vol 27 (2) ◽  
pp. 22-26
Author(s):  
NA Parveen ◽  
MM Sarker ◽  
MK Sarker
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Vaginal Bleeding ◽  
Tertiary Care ◽  
Lower Abdominal Pain ◽  
Reproductive Age ◽  
Age Group ◽  
Treatment Morbidity ◽  
Incidence Risk ◽  
Abnormal Vaginal Bleeding

Ectopic pregnancy is a common life-threating condition. Diagnosis is frequently missed and should be considered in any women in the reproductive age group presenting with abdominal pain or vaginal bleeding. This prospective observational study was conducted in RMCH to determine the incidence, risk factors, clinical presentation, treatment, morbidity and mortality associated with ectopic pregnancy. A total of 50 cases of ectopic pregnancy were operated during the study period giving the incidence of ectopic pregnancy of 8.02/1000 pregnancies. The age of the patient ranged from 18-37 years, with maximum (40%) between 26-30 years age group. 36% patients had delivered one child and 24% were nulliparous. 30% patients had pelvic inflammatory disease and 22% had history of previous abortion/ MR. All patients presented with lower abdominal pain, 68% presented with abnormal vaginal bleeding and 60% had amenorrhoea. Most of the patients were diagnosed by high clinical suspicion and confirmed by USG. 96% cases ectopic pregnancy occurred in the fallopian tube and ampullary part was mainly affected. Laparotomy followed by unilateral salphingectomy was performed in majority (60%) of cases. 22% cases ipsilateral salpingectomy with tubectomy other side and 12% cases salpingostomy were performed. The recovery of majority of patients was smooth and uneventful. There was no death in this study.TAJ 2014; 27(2): 22-26

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