scholarly journals Abdominal pain syndrome in girls, adolescents and young women with tumor-like formations of the uterine adnexa

2021 ◽  
Vol 11 (10) ◽  
pp. 135-142
Author(s):  
I. Tuchkina ◽  
M. Tuchkina ◽  
S. Kiebashvili

The article presents the clinical features of the complicated course of tumor-like formations of the uterine adnexa in girls, adolescents and young women.  The characteristic symptoms of adnexal torsion are described. Topographic and anatomic features leading to torsion of ovarian cysts and uterine appendages, features of the surgical treatment of patients with complicated adnexal torsion are presented. The aim was to study the frequency of occurrence of ovarian tumor-like formations and their complicated course in girls, adolescents and young women, improve early diagnosis and develop optimal methods of conserving surgical treatment of this pathology. Material and methods. The study included 90 girls, adolescents and young women. Patients were divided into three groups. 1 group included 30 young women; the 2nd group consisted of 35 adolescents 13-17 years; 3 group consisted of 25 girls from 2 to 12 years. Diagnostic complex included clinical, special gynecological, comprehensive laboratory, ultrasound (including doppler ultrasound) research, computer and magnetic resonance imaging (if indicated). Results and discussion. The final diagnosis of “Ovarian cyst” was verified in 46 of 90 patients (51,1 %): group 1 – 26 of 30 (86,6 %), in 2 – 18 of 35 (51,4 %), in 3 - 2 of 25 (8 %). It is established that the torsion of the uterine adnexa was detected in 44 of 90 patients: in 1 group – 13,3% of cases (4 of 30 young women), in 2 group – 48,5 % (17 of 35 adolescents), in 3 group – 92 % (23 of 25 girls). 76 surgeries were performed by laparoscopy with preservation of the ovarian reserve, 12 patients were treated conservatively with final diagnosis “Ovulatory syndrome” and “Retention cyst of the ovary”. Conclusions. Ovarian cyst as the cause of abdominal pain is significantly more often diagnosed in young reproductive age than in patients of prepubertal and pubertal age. In girls and adolescent girls with symptoms of acute abdomen the torsion of intact uterine adnexa was significantly more common than in adult patients, due to anatomical features of the internal reproductive organs and more a mobile lifestyle inherent in this age group. Optimal treatment of functional ovarian cyst is complex conservative therapy, surgical treatment of ovarian cysts at a young age is conducted under strict indications, treatment of choice is laparoscopy.

2021 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Oana Denisa Balalau ◽  
Ileana Maria Conea ◽  
Nicolae Bacalbasa ◽  
Anca Silvia Dumitriu ◽  
Stana Paunica ◽  
...  

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.


2018 ◽  
Vol 13 (1) ◽  
pp. 61-63
Author(s):  
Nishma Bajracharya ◽  
Aruna Karki ◽  
Ganesh Dangal ◽  
Hema Pradhan ◽  
Ranjana Shrestha ◽  
...  

Ovarian cysts are common findings in females of reproductive age. Mostly, they are non-neoplastic and hormonally dependent as follicular, simple, and corpus luteum cysts. Ovarian cysts are rarely grown to reach huge size without raising any symptoms. Most of the cases that have huge cysts present with pressure symptoms over the genitourinary system leading to urinary complaints or the respiratory system lead to respiratory embarrassment.Dermoid cysts account for 10–20% of all ovarian neoplasms. They are common in young women, especially at the age of 30 years.In most of cases, they are asymptomatic and can be discovered accidentally on clinical examination or ultrasonographic scan. They are usually indolent tumors with very slow rate of growth about 1.8 mm per year. Giant dermoid cysts have been infrequently reported in the literature.This is a case report of huge dermoid cyst weighing 25 kgs in a 42-year old perimenopausal lady that remained relatively asymptomatic. She underwent Laparotomy with ovarian cystectomy.


2016 ◽  
Vol 3 (2) ◽  
pp. 108-112
Author(s):  
Anatoly I. Ishchenko ◽  
A. A Ishchenko ◽  
A. A Bakhvalova ◽  
A. A Devitskiy ◽  
A. I Maksimov

There are considered two clinical cases of torsion of the single uterine appendages in patients of reproductive age without pregnancies in a history. Both patients previously were undergone to adnexectomy due to adnexal torsion. After clinical and laboratory examination and intraoperative endoscopic visualization of the pelvic organs it was decided advisory to limit the amount of surgical intervention by means of unwinding the uterus by laparoscopic method. Taking into account the adnexal torsion on the opposite side (with subsequent adnexectomy) in a history the main stage of the surgical treatment was supplemented by ovariopexy to prevent disease recurrence. Postoperative control for the restoration of blood supply to the ovarian tissues includes programmed laparoscopic examination, monochrome ultrasound scanning, color Doppler mapping (CDM), the study of blood levels of sex hormones, a common clinical and biochemical analyzes of blood, coagulogram.


2019 ◽  
Vol 23 (3) ◽  
pp. 154-156
Author(s):  
L. V. Adamyan ◽  
E. V. Sibirskaya ◽  
S. M. Sharkov ◽  
A. K. Fayzulin ◽  
Anastasia V. Vechernina

Currently, differential diagnostics and treatment of uterine adnexal torsion (UAT) in girls is not completely solved and is not an easy one because surgical and gynecological pathologies often intersect with each other. That is why, girls with abdominal pain are to be consulted by a gynecologist. The case discussed in the article demonstrates the problem with differential diagnostics in girls with “acute abdomen”. UAT differential diagnostics is not easy because this pathology has no clear clinical picture what complicates putting a correct diagnosis. UAT in girls is an acute pathology which has to be differentiated from the volume tumor-like formations in the ovaries, a frequent complication of which is an incomplete torsion of tumor leg or ovarian tumor which then leads to complete uterine adnexa torsion. Differential diagnostics should be done with other surgical pathologies such as acute appendicitis, omentum infiltration. Their clinical picture is characterized by a certain complex of symptoms which develops specific changes during the progress of the inflammatory process; this picture also depends on the anatomical peculiarities. Uterine adnexa torsion is met in 15-25% of girls with abdominal pain syndrome. The aim of this work is to demonstrate preventive measures so as to avoid possible diagnostic errors and complications associated with them in girls with abdominal pain syndrome.


Author(s):  
Meenakshi Gothwal ◽  
Aasma Nalwa ◽  
Garima Yadav ◽  
Mahendra Lodha ◽  
Pratibha Singh ◽  
...  

Giant ovarian cysts are very rare nowadays and were conventionally treated by full midline laparotomy. In recent years, the laparoscopic approach is also practiced but it needs a lot of expertise and only a few cases have been reported. As the surgical treatment of choice has become less invasive, laparoscopic surgery is considered more beneficial over laparotomy because of better cosmetic results, less blood loss, reduced postoperative analgesic requirement, early mobilization and faster discharge from the hospital and early resumption to normal day to day activity. We report a case of laparoscopic extirpation of a giant right ovarian cyst measuring 15 × 21 × 22 cm in young 24-year female.


PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5995 ◽  
Author(s):  
Ci Huang ◽  
Mun-Kun Hong ◽  
Tang-Yuan Chu ◽  
Dah-Ching Ding

Background Adnexal torsion is a gynecologic emergency that requires surgical treatment. In this study, we reviewed the surgical outcomes of women with adnexal torsion in eastern Taiwan (Hualien county, area 4,629 km2, 330,000 residents). Methods This retrospective study included 42 women diagnosed with surgically-proven adnexal torsion from January 1, 2010, to September 31, 2015. We compared the symptoms, objective findings, and surgical outcomes of patients who underwent laparotomy or laparoscopy. Results The laparoscopy and laparotomy groups included 27 and 15 patients, respectively. The most common symptom and sign was abdominal pain, followed by nausea and vomiting. In all patients, an adnexal tumor was detected through ultrasound. The median and range of time from admission to surgery was 1.5 (1–11.5) and 1.0 (1–11) hours in the laparotomy and laparoscopy groups, respectively. Compared with those undergoing laparotomy, the smaller tumor size [7 (4.2–10) vs. 10 (7–17) cm] and shorter hospital stay [4 (2–8) vs. 6 (3–9) days] in patients undergoing laparoscopy were significantly noted, respectively (P < 0.01). No differences were observed in age, operative time, and blood loss between both groups. The surgeries performed were mostly detorsion with cystectomy and adnexectomy. The most common pathology was a simple ovarian cyst, followed by teratoma. Regarding the surgical types, older age is the only risk factor for radical surgery. Discussion Acute onset of abdominal pain with a presenting ovarian tumor is the most common feature of adnexal torsion. Laparoscopic surgical group showed a small tumor size and a short ER hospital stay than laparotomy. Older age is the risk factor for radical surgery.


2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Babatola Bakare ◽  
Olumide Akadiri ◽  
Akinyemi Akinsoji Akintayo

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.


2019 ◽  
Vol 9 (2) ◽  
pp. 144-150
Author(s):  
S. F. Taychinova ◽  
Sh. Kh. Gantsev ◽  
A. Z. Mullagalina ◽  
G. R. Akberdina

Introduction. The incidence of ovarian cyst amounts to 5–17 % in postmenopausal women. Currently monitoring of or screening for ovarian cysts in menopausal patients is not regimented in the Russian Federation at all. This situation warrants a review.Materials and methods. In this paper the authors review retrospective and prospective studies concerning outcomes in patients with ovarian cysts in menopause published in the last 5 years. Results. The retrospective and prospective studies analysed show that the risk of malignancy of this type of benign neoplasm is low, on average 0.7%. The results of a large prospective study prove that there is no need for surgical treatment in 80% of patients.Discussion. There is now doubt that patients with this disorder should be followed up in accordance with an algorithm that clearly defines the criteria for surgical treatment and the follow up length. Surgical treatment should be indicated when there is at least one of the signs of an ovarian cyst: symptomatic, texture not smooth, over 50 mm in diameter, multilocular, bilateral. A positive CA-125 in combination with ultrasound, MRI and CT imaging make it possible to calculate the risk index with the use of a particular formula and determine the indications for a risk-reducing bilateral salpingo-oophorectomy. The follow up of BRCA1/2 mutation-free patients with a benign ovarian neoplasm should include a close step-by-step monitoring and all the necessary examinations performed in a timely manner.Conclusion. The risk of a malignant transformation of an ovarian cyst in menopause is rather low (about 0.7%); following up patients with simple ovarian cysts in menopause is possible and should be carried out in strict compliance with the algorithm; the preventive bilateral salpingo-oophorectomy in patients presenting no signs of ovarian pathology is indicated only for the high risk group (BRCA1/2 mutations confirmed or there is family history).


Author(s):  
N.V. Mashinets, V.N. Demidov

Case report of prenatal diagnosis of bilateral complicated ovarian cysts of the fetus at 34 weeks of pregnancy is presented. The particularity of this case is that one ovarian cyst in the fetus was complicated by intrauterine torsion, which required surgical treatment after birth. In the cavity of the second cyst, hemorrhage occurred with spontaneous regression, which did not require surgical intervention.


2016 ◽  
Vol 33 (1) ◽  
pp. 47-49 ◽  
Author(s):  
Christopher Kiefer ◽  
Joseph Minardi ◽  
Debra Williams ◽  
Shelley M. Layman

Abdominal pain in women of reproductive age is a frequently encountered chief complaint in the emergency department. Adnexal torsion is a time-sensitive diagnosis that is essential for emergency physicians to consider in the initial differential diagnosis. Bedside sonography can be used to assist the clinician in the detection of adnexal masses placing the patient at risk for torsion. Lipoleiomyomas are uncommon, benign neoplasms consisting of variable portions of mature lipocytes, smooth muscle, or fibrous tissue. Very few cases have been reported, with no cases previously reported by emergency physicians using bedside ultrasound. A case is presented of a middle-aged woman who presented to the emergency department with acute lower abdominal pain. At the time of the initial history and physical examination, bedside screening sonogram was performed, which allowed rapid diagnosis of a large, heterogeneous, relatively avascular adnexal mass that was later identified as a lipoleiomyoma, a rare adnexal neoplasm, that resulted in adnexal torsion.


Sign in / Sign up

Export Citation Format

Share Document