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World Journal of Clinical Cases Feb 2024Cystic lymphangioma is a rare benign tumor that affects the lymphatic system. Mesenteric lymphangiomas in the small bowel are extremely uncommon.
BACKGROUND
Cystic lymphangioma is a rare benign tumor that affects the lymphatic system. Mesenteric lymphangiomas in the small bowel are extremely uncommon.
CASE SUMMARY
We present a 21-year-old female patient who complained of abdominal pain. The diagnosis of ovarian torsion was suspected after abdominopelvic unenhanced computed tomography and ultrasound revealed a large cyst in contact with the bladder, ovary, and uterus. The patient underwent emergency laparotomy performed by gynecologists, but it was discovered that the cystic tumor originated from the jejunum. Gastrointestinal surgeons were then called in to perform a cystectomy. Pathological examination confirmed the diagnosis of cystic lymphangioma of the mesentery. The patient had an uneventful postoperative recovery.
CONCLUSION
Mesenteric lymphangiomas can cause abdominal pain, and imaging techniques can help determine their characteristics, location, and size. Complete surgical excision and pathological examination are considered the standard treatment and diagnostic method.
PubMed: 38322678
DOI: 10.12998/wjcc.v12.i4.847 -
African Journal of Paediatric Surgery :... Jan 2024The routine schedule of antenatal ultrasound scans has led to an increased frequency of detection of foetal ovarian cysts. Although most of them regress spontaneously,...
The routine schedule of antenatal ultrasound scans has led to an increased frequency of detection of foetal ovarian cysts. Although most of them regress spontaneously, some may grow into large cysts and undergo torsion followed by auto-amputation. However, pre- and post-natal scans may fail to identify this event. We report a case of a prenatally diagnosed ovarian cyst that failed to resolve conservatively and was increasing in size in post-natal ultrasounds. Pre-operative ultrasound and magnetic resonance imaging failed to detect the auto-amputation. The diagnosis was confirmed on laparoscopy which offers a safe and effective method for the removal of ovarian cysts in neonates and infants.
Topics: Female; Humans; Infant; Laparoscopy; Ovarian Cysts
PubMed: 38259022
DOI: 10.4103/ajps.ajps_30_22 -
Journal of Menopausal Medicine Dec 2023
PubMed: 38230597
DOI: 10.6118/jmm.23022 -
Case Reports in Women's Health Mar 2024Adnexal torsion is an emergency commonly presenting in women of reproductive age. Timely diagnosis and management are needed to preserve the ovary. Recurrence is more...
Adnexal torsion is an emergency commonly presenting in women of reproductive age. Timely diagnosis and management are needed to preserve the ovary. Recurrence is more uncommon. This article presents a case of recurrent torsion, and reviews the literature to highlight the significance of early diagnosis and management. The case is presented of a nulliparous 31-year-old woman who presented on five occasions with symptoms of acute pain and vomiting. Adnexal torsion was suspected on clinical assessment and ultrasound scan. She was found to have left-sided isolated fallopian tube torsion twice, and tubo-ovarian torsion on two occasions. Detorsion was performed four times. Bilateral oophoropexy was performed during an emergency laparoscopy on the fourth presentation. The left ovary was conserved, but viability was doubted. She presented four weeks later with similar symptoms. An intraoperative finding was of an auto-amputated left ovary with no attachment to infudibulopelvic ligament. This ovary was removed. Operative management was performed promptly, but planned oophoropexy was delayed, and an earlier procedure may have resulted in conservation of the ovary. There is no standardised management for prevention of recurrent ovarian torsion. The benefits of oophoropexy to prevent further torsion versus risks lack evidence. There is also debate as to the method by which oophoropexy is done. There is no consensus or guideline regarding the best management approach for recurrent adnexal torsion. Further research is needed to obtain evidence to support clinicians in discussing management options with their patients.
PubMed: 38204560
DOI: 10.1016/j.crwh.2023.e00575 -
Revista de La Facultad de Ciencias... Dec 2023The paraovarian or paratubarian cysts are both situated in the broad ligament between the ovary and fallopian tube. The diagnosis of adnexal torsion is challenging...
The paraovarian or paratubarian cysts are both situated in the broad ligament between the ovary and fallopian tube. The diagnosis of adnexal torsion is challenging since both symptoms and physical examination are nonspecific. In most cases, the patient presents abdominal pain, followed by nausea and vomiting. Imaging tests, such as ultrasound, are very useful to elucidate the cause of the symptoms in those patients.
Topics: Female; Humans; Ovarian Torsion; Cysts; Abdominal Pain
PubMed: 38150207
DOI: 10.31053/1853.0605.v80.n4.40830 -
Case Reports in Medicine 2023This article presents a case of spontaneous autoamputation of ovary in a 46-year-old nulligravid woman with a history of rheumatoid arthritis and hypertension, who...
A Case of Spontaneous Autoamputation of Ovary in a 46-Year-Old Woman: An Uncommon Presentation (Painless Ovarian Torsion) with Unique Diagnostic and Therapeutic Challenges.
This article presents a case of spontaneous autoamputation of ovary in a 46-year-old nulligravid woman with a history of rheumatoid arthritis and hypertension, who presented with secondary amenorrhea and white vaginal discharge. Despite an initial diagnosis of dermoid cyst based on ultrasound findings, subsequent laparoscopic surgery revealed a necrotized oval-shaped mass in the cul-de-sac, which was identified as the right ovary that had undergone torsion and autoamputation. This case highlights the diagnostic and therapeutic challenges associated with this uncommon presentation, which may be easily misdiagnosed. Clinicians should consider spontaneous autoamputation of ovary as a potential differential diagnosis in women presenting with adnexal masses, even if there is no prior history of abdominal pain.
PubMed: 38116295
DOI: 10.1155/2023/2165226 -
Sultan Qaboos University Medical Journal Nov 2023Hypoplasia of the lung is an uncommon congenital abnormality of the respiratory system in contrast to pulmonary agenesis. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome...
Hypoplasia of the lung is an uncommon congenital abnormality of the respiratory system in contrast to pulmonary agenesis. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is the congenital absence of the upper two-thirds of the vagina and uterus with normal secondary sexual characteristics, ovary and normal karyotype. We report a 31-year-old female patient who presented in 2022 with cough with expectoration, left-side chest pain and breathlessness for 4 years to tertiary hospital, Puducherry, India. She was evaluated for amenorrhoea and diagnosed as MRKH syndrome and the patient underwent right-side oophorectomy for right ovarian torsion with a tumour. Computed tomography pulmonary angiogram and fiberoptic endoscopy were suggestive of left lung hypoplasia and the patient was advised symptomatic treatment for lung hypoplasia and planned for vaginoplasty for which she refused.
Topics: Female; Humans; Adult; Abnormalities, Multiple; Heart Defects, Congenital; Ovarian Neoplasms; Lung
PubMed: 38090232
DOI: 10.18295/squmj.1.2023.012 -
Pediatric Quality & Safety 2023Transabdominal pelvic ultrasound (TPUS) is the diagnostic test of choice for the evaluation of ovarian torsion, a time-sensitive surgical emergency. A full bladder is...
BACKGROUND
Transabdominal pelvic ultrasound (TPUS) is the diagnostic test of choice for the evaluation of ovarian torsion, a time-sensitive surgical emergency. A full bladder is required to visualize the ovaries. Bladder filling is a time-consuming process leading to delays to TPUS, poor visualization of ovaries requiring repeat studies, and prolonged emergency department length of stay (ED LOS). The primary objective was to decrease the time to TPUS by standardizing the bladder filling process.
METHODS
This quality improvement initiative occurred at a single, academic, quaternary-care children's hospital ED and utilized the Institute for Healthcare Improvement Model for Improvement with sequential plan-do-study-act cycles. The first set of interventions implemented in August 2021 included a new electronic order set and bladder scan by ED nurses. Subsequent plan-do-study-act cycles aimed to decrease the time to intravenous fluid, decrease fluid requirement, and decrease the need for intravenous fluid. The primary outcome measure was the monthly mean time to TPUS. Secondary outcome measures included monthly mean ED LOS and percentage of repeat TPUS. We performed data analysis with statistical process control charts to assess for system change over time.
RESULTS
The preintervention baseline included 292 ED encounters more than 10 months, and postintervention analysis included 526 ED encounters more than 16 months. Time to TPUS decreased (138-120 min), ED LOS decreased (372-335 min), and repeat TPUS decreased (18% to 4%). All changes met the rules for special cause variation.
CONCLUSIONS
Standardizing the bladder filling process was associated with decreased time to TPUS, ED LOS, and repeat TPUS.
PubMed: 38089831
DOI: 10.1097/pq9.0000000000000709 -
Qatar Medical Journal 2023The ovary's Torsion is the adnexa's total or partial rotation around its vascular axis or pedicle. Complete torsion causes venous and lymphatic blockade leading to...
The ovary's Torsion is the adnexa's total or partial rotation around its vascular axis or pedicle. Complete torsion causes venous and lymphatic blockade leading to stasis, venous congestion, hemorrhage, and necrosis. If neglected, it may result in permanent loss of the affected ovary. Ovarian torsion is one of the most critical gynecological surgical emergencies. Therefore, it requires urgent surgical intervention. It is mainly diagnosed by clinical examination and ultrasound. Ovarian torsion is primarily seen in the first trimester of pregnancy. Infertility treatment is a significant risk factor due to ovarian stimulation. We present a case of acute abdominal pain who came to the emergency department of Al Ahli Hospital, diagnosed as right adnexal torsion with viable intrauterine pregnancy at six weeks. Laparoscopic oophorectomy was done by removing the corpus luteum cyst, which supports early pregnancy. Despite its disposal, the pregnancy continued because the hormonal therapy started in doses higher than recommended for threatened abortion. Eventually, she gave birth to a healthy baby boy at 35 weeks.
PubMed: 38089671
DOI: 10.5339/qmj.2023.22 -
Cureus Nov 2023Torsion of the ovarian cyst is a gynecological emergency that can arise during pregnancy. Regardless of gestational age, surgical procedures should be explored in the...
Torsion of the ovarian cyst is a gynecological emergency that can arise during pregnancy. Regardless of gestational age, surgical procedures should be explored in the course of the growth of adnexal torsion. Although ovarian torsion is not as common during pregnancy and may be an incidental finding, it is always better to stay cautious. If neglected, they may be deemed hazardous to both the baby and the mother. Here we are reporting a case of a 25-year-old multigravida woman who is in the first trimester of her pregnancy, and presented with the complaint of acute abdominal pain for 3 days. On ultrasound, torsion of the right ovarian cyst was found. She underwent laparoscopy and a right-sided salpingo-oophorectomy was done. The biopsy report revealed a benign hemorrhagic cyst. She has been under observation and is asymptomatic, with clear imaging and laboratory values.
PubMed: 38074002
DOI: 10.7759/cureus.48406