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BMC Pregnancy and Childbirth Apr 2023Spontaneous uterine venous rupture combined with ovarian rupture in late pregnancy is extremely rare. It often has an insidious onset and atypical symptoms, develops...
BACKGROUND
Spontaneous uterine venous rupture combined with ovarian rupture in late pregnancy is extremely rare. It often has an insidious onset and atypical symptoms, develops rapidly, and is easily misdiagnosed. Wewould like to discuss and share this case of spontaneous uterine venous plexus combined with ovarian rupture in the third trimester of pregnancy with colleagues.
CASE PRESENTATION
A pregnant woman, G1P0 at 33 weeks of gestation,was admitted to the hospital due to threatened preterm labour on March 3, 2022. After admission, she was treated with tocolytic inhibitors and foetal lung maturation agents. The patient's symptoms did not improve during the treatment. After many examinations, tests, discussions, a diagnosis, and a caesarean section, the patient was finally diagnosed with atypical pregnancy complicated by spontaneous uterine venous plexus and ovarian rupture.
CONCLUSIONS
Spontaneous rupture of the uterine venous plexus combined with ovarian rupture in late pregnancy is an occult and easily misdiagnosed condition, and the consequences are serious. Clinical attention should be given to the disease and prevention attempted to avoid adverse pregnancy outcomes.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Pregnancy Trimester, Third; Cesarean Section; Uterine Rupture; Uterus; Pregnancy Outcome; Rupture, Spontaneous
PubMed: 37055719
DOI: 10.1186/s12884-023-05556-y -
The British Journal of Radiology Jan 2021Corpus luteum rupture presenting as acute abdomen is an underdiagnosed condition. Though a self-limiting entity, its differentiation from other causes is essential to... (Review)
Review
Corpus luteum rupture presenting as acute abdomen is an underdiagnosed condition. Though a self-limiting entity, its differentiation from other causes is essential to prevent unnecessary surgical procedures. The radiologist should be aware of the possibility of a ruptured haemorrhagic ovarian cyst in a female of reproductive age group presenting with pelvic pain and a large amount of haemorrhagic ascites. Imaging characteristically reveals a thick-walled cystic structure in the adnexa with internal echoes, focal discontinuity or irregularity of its wall with haemoperitoneum. While sonography is usually indicative of corpus luteum rupture, cross-sectional imaging (CT/MRI) can be used to confirm the diagnosis.
Topics: Abdomen, Acute; Corpus Luteum; Diagnosis, Differential; Female; Hemoperitoneum; Humans; Magnetic Resonance Imaging; Multimodal Imaging; Rupture, Spontaneous; Tomography, X-Ray Computed; Ultrasonography
PubMed: 32822245
DOI: 10.1259/bjr.20200383 -
American Journal of Perinatology May 2012Ovarian tumors first diagnosed during pregnancy often present a challenge for both the obstetrician and gynecologists providing pregnancy care and for the consulting... (Review)
Review
Ovarian tumors first diagnosed during pregnancy often present a challenge for both the obstetrician and gynecologists providing pregnancy care and for the consulting subspecialists. Although the vast majority of these tumors is benign, on rare occasions, patients present with tumors that turn out to be malignant requiring more comprehensive and extensive surgical procedures that are more likely to lead to pregnancy loss. Hence accurate knowledge of tumor characteristics, especially the ultrasound appearance and gestational age at diagnosis, are key prerequisite for establishing the most effective management plan not just for the index but also for future pregnancies. The primary objective of the current review is to provide practical guidelines for the evaluation and management of ovarian tumors first diagnosed during pregnancy.
Topics: Biomarkers; CA-125 Antigen; Diagnostic Imaging; Female; Humans; Laparoscopy; Laparotomy; Ovarian Cysts; Ovarian Neoplasms; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy Trimesters; Rupture; Torsion Abnormality; Watchful Waiting
PubMed: 22131044
DOI: 10.1055/s-0031-1295641 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jul 2021Rupture of gynecologic tumors secondary to trauma rarely occurs. Rupture can lead to acute abdominal pain due to hemorrhage from the ruptured area and organs; rupture...
Rupture of gynecologic tumors secondary to trauma rarely occurs. Rupture can lead to acute abdominal pain due to hemorrhage from the ruptured area and organs; rupture can also lead to peritonitis, depending on the size of the tumor. We describe the case of giant epithelial ovarian tumor rupture exhibiting due to minor trauma and the development of hypovolemic shock. A 69-year-old female patient was admitted to the emergency room with complaints of acute abdominal pain and subsequent clouding of consciousness after falling down while walking. Emergency abdominal computed tomography scan revealed widespread hemorrhagic free fluid in the abdominal cavity and a mass measuring 27.5 cm × 21 cm × 15 cm, extending from the right quadrant of the abdomen to the left. The patient underwent an emergency operation due to hypovolemic shock. During surgery, a totally ruptured mass lesion arising from the right ovary was seen; the mass contained cystic components and measured approximately 30 cm × 20 cm × 15 cm. Hemostasis was achieved in the bleeding areas, and the right ovarian mass was totally resected. The patient was discharged as cured on the 6th post-operative day. Gynecologic tumor rupture due to trauma is a rare event. However, it is a clinical condition that should be kept in mind regardless of the type of trauma. This is especially true in patients who experienced trauma and were radiologically found to have intra-abdominal hemorrhage with normal-appearing solid organs, such as liver and spleen, that frequently cause bleeding.
Topics: Aged; Female; Humans; Ovarian Neoplasms; Ovary; Rupture, Spontaneous; Shock; Tomography, X-Ray Computed
PubMed: 34212991
DOI: 10.14744/tjtes.2020.07045 -
Best Practice & Research. Clinical... Aug 2015Ovarian, fallopian tube, and peritoneal cancers have a similar clinical presentation and are treated similarly, and current evidence supports staging all three cancers... (Review)
Review
Ovarian, fallopian tube, and peritoneal cancers have a similar clinical presentation and are treated similarly, and current evidence supports staging all three cancers in a single system. The primary site (i.e., ovary, fallopian tube, or peritoneum) should be designated where possible. The histologic type should be recorded. Intraoperative rupture ("surgical spill") is IC1; capsule ruptured before surgery or tumor on ovarian or fallopian tube surface is IC2; and positive peritoneal cytology with or without rupture is IC3. The new staging includes a revision of stage III patients; assignment to stage IIIA1 is based on spread to the retroperitoneal lymph nodes without intraperitoneal dissemination. Extension of the tumor from the omentum to the spleen or liver (stage IIIC) should be differentiated from isolated parenchymal metastases (stage IVB).
Topics: Adenocarcinoma, Clear Cell; Adenocarcinoma, Mucinous; Carcinoma, Endometrioid; Fallopian Tube Neoplasms; Female; Humans; Lymph Nodes; Neoplasm Staging; Neoplasms, Cystic, Mucinous, and Serous; Ovarian Neoplasms; Peritoneal Neoplasms
PubMed: 25890882
DOI: 10.1016/j.bpobgyn.2015.03.006 -
Medicine Jul 2023Ovarian hyperstimulation syndrome (OHSS) is a common complication during assisted conception treatment, mostly seen in patients with ovarian hyperresponsiveness such as...
INTRODUCTION
Ovarian hyperstimulation syndrome (OHSS) is a common complication during assisted conception treatment, mostly seen in patients with ovarian hyperresponsiveness such as polycystic ovary syndrome, especially in post-invitro fertilization and embryo transfer (IVF-ET) pregnancies. Its main symptoms are abdominal distension, abdominal pain, nausea and vomiting with ascites, pleural fluid, leukocytosis, hemoconcentration and hypercoagulation. This disease is a self-limiting disease and can be gradually cured by rehydration, albumin infusion and correction of electrolyte disorders in moderate to severe cases. Luteal rupture is a more common gynecological emergency abdomen. The combination of twin pregnancy, OHSS and ruptured corpus luteum is very rare. We successfully avoided the stimulation of the risk of pregnancy abortion by surgical exploration through dynamic ultrasound monitoring and vital signs observation in the absence of experience in primary care, and the patient hard-won twin pregnancy was successfully treated conservatively.
PATIENT CONCERNS
The patient is a 30-year-old post-IVF-ET woman with an established twin pregnancy, OHSS and sudden onset of lower abdominal pain.
DIAGNOSIS
Twin pregnancy, OHSS combined with ruptured corpus luteum.
INTERVENTIONS
Rehydration, albumin infusion, low molecular heparin for thromboprophylaxis, luteinizing support, ambulatory ultrasound monitoring.
OUTCOMES
After more than 10 days of standardized treatment for OHSS, dynamic ultrasound monitoring and close observation of vital signs, the patient was discharged cured of her condition and is continuing her pregnancy.
CONCLUSION
Our case shows that the possibility of acute abdominal rupture of the corpus luteum is still present in the case of combined OHSS in pregnancy, and that some patients with corpus luteum rupture can heal spontaneously during close testing to avoid the increased risk of miscarriage with surgical exploration.
Topics: Humans; Pregnancy; Female; Adult; Ovarian Hyperstimulation Syndrome; Pregnancy, Twin; Fertilization in Vitro; Anticoagulants; Venous Thromboembolism; Corpus Luteum; Abortion, Spontaneous; Embryo Transfer; Abdominal Pain; Albumins; Ovulation Induction
PubMed: 37417637
DOI: 10.1097/MD.0000000000034238 -
Journal of Clinical Pathology Nov 2005This report describes the case of an asymptomatic, solitary splenotic nodule in the right ovary, revealed incidentally at histopathological examination. In...
This report describes the case of an asymptomatic, solitary splenotic nodule in the right ovary, revealed incidentally at histopathological examination. In gynaecological patients, splenosis most often presents as multiple pelvic nodules mimicking endometriosis. Two cases of ovarian splenosis accompanying pelvic and serosal splenotic nodules have been reported previously. However, this is the first documented case of solitary intraovarian splenosis.
Topics: Female; Humans; Middle Aged; Ovarian Diseases; Spleen; Splenosis
PubMed: 16254119
DOI: 10.1136/jcp.2005.026104 -
The Journal of Obstetrics and... Mar 2012Laparoscopy is the gold standard for treatment of benign ovarian cysts, although there is a risk of intraoperative cyst rupture if the lesion is cancerous. This study is... (Comparative Study)
Comparative Study
AIM
Laparoscopy is the gold standard for treatment of benign ovarian cysts, although there is a risk of intraoperative cyst rupture if the lesion is cancerous. This study is aimed at comparing the incidence of cyst rupture to tumor size in both laparotomy and laparoscopy in order to select the optimum surgical procedure for ovarian cysts.
METHODS
A total of 1483 cases of benign ovarian cysts were surgically treated at our center between 1995 and 2010. These cases were divided into three groups according to the maximum diameter of the ovarian tumors: <5 cm, ≥5 cm but <10 cm, and ≥10 cm. The incidence of cyst rupture was compared between laparotomy and laparoscopy according to the size of the tumor in ovarian tumorectomy and adnexectomy.
RESULTS
The incidence of cyst rupture was significantly higher in ovarian tumorectomy by laparoscopy than by laparotomy. Cyst rupture occurred independent of the tumor size in both laparoscopy and laparotomy. For adnexectomy for tumors smaller than 10 cm, there was no significant difference by tumor size in the incidence of cyst rupture between laparoscopy and laparotomy; however, the incidence of cyst rupture was significantly higher in laparoscopy of tumors sized 10 cm or larger than in the laparotomy of tumors of similar size; the incidence was also greater than laparoscopy of tumors smaller than 10 cm.
CONCLUSION
Laparotomy, rather than laparoscopy, is recommended in cases of ovarian cysts with any finding suggestive of malignancy.
Topics: Female; Humans; Incidence; Intraoperative Complications; Laparoscopy; Laparotomy; Ovarian Cysts; Ovariectomy; Rupture
PubMed: 22353442
DOI: 10.1111/j.1447-0756.2011.01748.x -
The Journal of Maternal-fetal &... 2016Fetal ovarian cysts are the most frequent type of abdominal tumors in female fetuses with prenatal detection rate of more than 30%. The etiology of fetal ovarian cysts...
Fetal ovarian cysts are the most frequent type of abdominal tumors in female fetuses with prenatal detection rate of more than 30%. The etiology of fetal ovarian cysts is unclear, but hormonal stimulation as well as presence of maternal diabetes, hypothyroidism, Rh iso-immune hemolytic disease and toxemia has been generally considered responsible for the disease. Complications of fetal ovarian cysts include compression of other viscera, cyst rupture, hemorrhage and, most frequently, ovarian torsion with consequent loss of the ovary. Management is controversial with several options described in the literature, including watchful expectancy, antenatal aspiration of simple cysts to prevent torsion and ovarian loss and finally, resection of all complex cysts in the neonatal period. To date, no case report has described recurrent complex cysts with rupture in the fetal period and recurrence of simple cyst in neonatal period. By presenting this case, we wanted to show that surgical intervention in case of prenatally diagnosed fetal ovarian cyst should be considered postnatally and only in symptomatic or complicated cases.
Topics: Adult; Female; Fetal Diseases; Humans; Ovarian Cysts; Pregnancy; Recurrence; Rupture, Spontaneous; Ultrasonography, Prenatal
PubMed: 25567557
DOI: 10.3109/14767058.2014.1000851 -
Annali Italiani Di Chirurgia 2009The Authors report the case of a 9-year-old girl suffering from acute abdominal pain, combined with mild anaemia (Hb 10.9 g/dL), leukocytosis (24.3 x 10(3) cells/dL),... (Review)
Review
The Authors report the case of a 9-year-old girl suffering from acute abdominal pain, combined with mild anaemia (Hb 10.9 g/dL), leukocytosis (24.3 x 10(3) cells/dL), and a large palpable mass in the upper left quadrant. The child underwent an appendectomy 20 days before the admission to our Department. The operation performed in urgency, as well as the removal of a bulky mass situated in the left flank and the right ovary whence it arose, made it clear that abdominal signs and symptoms were caused by the twisting and rupturing of a neoformation, that would hence cause an impressive hemoperitoneum. The histopathologic examination showed a three-germ layer mature mixed teratoma. Clinical, radiologic and biochemical test (alpha-FP, beta-hcG) performed in a postoperative 2 months follow-up revealed no residual disease.
Topics: Abdominal Pain; Child; Female; Hemoperitoneum; Humans; Ovarian Neoplasms; Rupture, Spontaneous; Teratoma; Treatment Outcome
PubMed: 19681297
DOI: No ID Found