scholarly journals Acute Diffuse Peritonitis Due to Spontaneous Rupture of an Infected Endometrioma: A Case Report

2021 ◽  
Vol 28 (2) ◽  
pp. 20
Author(s):  
Evelina Petruškevičiūtė ◽  
Diana Bužinskienė
Keyword(s):  
Abdominal Pain ◽  
Acute Inflammation ◽  
Reproductive Age ◽  
Ovarian Cysts ◽  
Diffuse Peritonitis ◽  
Ovarian Endometriosis ◽  
Diffuse Abdominal Pain ◽  
Midline Laparotomy ◽  
Acute Peritonitis ◽  
Ovarian Endometrioma

Background. Endometriosis is defined as a chronic, inflammatory, estrogen-dependent gynaecologic disease. It affects approximately 5–10% of reproductive-age women worldwide. Ovarian endometriosis is the most frequent form of this condition. Endometriotic cysts are found in about 17–44% of women diagnosed with endometriosis. It is well known, that ovarian endometriomas can cause infertility and chronic pelvic pain. Enlarging cysts can also cause ovarian torsion. In addition, ovarian endometriosis slightly increases the risk for ovarian cancer. The rupture of endometriotic ovarian cysts is an exceptional complication. According to the literature, the prevalence is less than 3% among women with endometriosis. The rupture of an ovarian endometrioma can cause acute peritonitis, which can lead to sepsis, septic shock and can be lethal. The occurrence of abscesses within an ovarian endometrioma is an extremely rare complication. Generally, the origin of infected endometriotic ovarian cysts is related to the previous invasive procedures involving pelvic organs or the use of intrauterine devices. Also, ovarian abscesses can be caused by the hematogenous or lymphatic spread of bacteria. Although, the literature points out that infection of endometriotic ovarian cysts can develop spontaneously. In these rare cases, reservoir and route of infection remains an enigma.Case report. A 49-year-old female was brought to the emergency room with severe generalized lower abdominal pain (6/10) and three days lasting fever. Abdominal examination revealed diffuse abdominal pain with anterior abdominal wall muscle tension. Painful solid masses were felt on both sides of the uterus during the pelvic examination. Cystic masses were detected in both ovaries during transvaginal sonography. Computer tomography (CT) of the abdomen and pelvis revealed abnormal changes in both ovaries. A small amount of free fluid was found in the pelvic cavity along with thickened pelvic peritoneum. Suspecting acute peritonitis and bilateral tubo-ovarian abscesses, surgical treatment was performed. Lower midline laparotomy with bilateral adnexectomy and abdominal lavage with 4000 ml normal saline were done. The outcome of peritonitis was evaluated using the Mannheim peritonitis index (MPI=17 – low risk of morbidity and mortality). The histopathological examination revealed the diagnosis of bilateral endometriotic cysts complicated with acute inflammation, with associated acute inflammation of both fallopian tubes. Microbiological cultures from the purulent fluid were negative.Conclusions. Although the occurrence of abscesses within an ovarian endometrioma is an extremely rare finding in clinical practice, it has to be considered by gynaecologists because it might result in a surgical emergency that can be life-threatening. Being aware of the risk factors of abscesses within an endometrioma can lead to an early diagnosis of this rare condition and help to avoid serious complications.

scholarly journals Pneumoperitoneum due to perforated appendicitis: a rare anatomo-radiologic correlation

2008 ◽  
Vol 21 (3) ◽  
pp. 142-143
Author(s):  
André Luiz Santos Rodrigues ◽  
Marcelino Ferreira Lobato ◽  
Augusto César Santana ◽  
Lucas Crociati Meguins ◽  
Daniel Felgueiras Rolo
Keyword(s):  
Peptic Ulcer ◽  
Severe Sepsis ◽  
Abdominal Pain ◽  
Case Report ◽  
Medical Literature ◽  
Perforated Appendicitis ◽  
Perforated Peptic Ulcer ◽  
Exploratory Laparotomy ◽  
Diffuse Peritonitis ◽  
Diffuse Abdominal Pain

BACKGROUND: Pneumoperitoneum is usually associated with a perforated peptic ulcer. However, perforated appendicits may be evolved on it. In the medical literature, the anatomo-radiologic correlation between them is an uncommon event. CASE REPORT: Man with 56-year-old look for assistance with diffuse abdominal pain and distension associated with fever, vomit and absence of flatus and evacuation for about 14 days. The chest radiography revealed a pneumoperitoneum. Diffuse peritonitis was found during the exploratory laparotomy. Appendectomy, peritoneal cavity cleaning and drainage with tubular drains were carried out. However, severe sepsis occurred and the patient died on the 16th post-operative day with multiple systemic organ failure. CONCLUSION: Although rare as pneumoperitoneum ethiology, acute appendicitis may be thought as it's cause.

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
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Young Women ◽  
Ovarian Cyst ◽  
Pain Syndrome ◽  
Final Diagnosis ◽  
Reproductive Age ◽  
Ovarian Cysts ◽  
Adnexal Torsion ◽  
Complicated Course

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.

Clinical and sonological features in endometriomas in women of reproductive age

2016 ◽  
pp. 85-89
Author(s):  
О. Shapoval ◽  
Keyword(s):  
Endometrial Hyperplasia ◽  
Benign Tumor ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Ovarian Endometriosis ◽  
Gynecological Examination ◽  
Different Characteristics ◽  
Ovarian Endometriomas

The objective: to study the prevalence of ovarian endometriosis in women of reproductive age, the features of clinical and ultrasound picture of endometriosis. Patients and methods. The study involved 22 patients with endometriomas, the control group – 50 women gynecological and somatically healthy. Results. The incidence of ovarian endometriomas in the structure of benign tumor-like formations of ovaries is 0.62%. In 72.73% of ovarian endometriomas occur on a background of concomitant gynecological pathology. Clinically, in 77.27% of cases there is a pain syndrome, in 59.09% – algomenorrhea, in 13.64% – infertility; 18.18% of cases endometriomas remain «dumb» and proceed with the erased clinical picture. Sonologically in patients with endometriomas adenomyosis, endometrial hyperplasia, changes in the contralateral ovary are determined. Conclusion. Without additional methods of diagnostic gynecological examination may identify the 3 cm tumor-like formation of the ovary with different characteristics, which does not allow to differentiate endometrioma from inflammation, functional and ovarian tumors. Ultrasound can diagnose pathological ovarian formation of 1 cm, detailing the nature of the cyst. Key words: endometriosis, reproductive age, retrospective analysis, ultrasound.

Bilateral ovarian cysts of mature cystic teratoma and Endometrioma: Its surgical challenges and review of literature

2021 ◽  
pp. 228402652110321
Author(s):  
Vimee Bindra ◽  
Mamatha Reddy ◽  
Girija Shankar Mohanty ◽  
Neha Agarwal ◽  
Aditya Kulkarni
Keyword(s):  
Dermoid Cyst ◽  
Germ Cell Tumors ◽  
Cystic Teratoma ◽  
Pelvic Endometriosis ◽  
Review Of Literature ◽  
Ovarian Endometriosis ◽  
Nulliparous Women ◽  
Ovarian Endometrioma ◽  
Ovarian Endometriomas

Teratomas are most frequent germ cell tumors of ovary with an incidence of 15%–20% of all ovarian neoplasm while endometriomas are present in 25.5%–45% of women with pelvic endometriosis. In spite of their increased individual incidence, association of cystic teratomas and ovarian endometriomas is extremely rare. Our case is that of a 33-year-old nulligravida who presented with heavy menstrual flow and pain during periods for last few months, ultrasonography revealed 74 × 57 mm mass in right adnexa-likely ovarian dermoid, enlarged left ovary with two small cysts of size 33 × 29 mm and 25 × 20 mm likely endometrioma, managed by laparoscopy, found to have left ovarian endometrioma of 6 × 6 cm and right ovarian dermoid cyst of 10 × 8 cm size, histopathology confirmed the same. This association of teratoma in one ovary and endometrioma in other ovary of same patient poses a surgical challenge, when it affects young and nulliparous women. Further follow up is mandatory for this simultaneous finding of ovarian endometriosis with coincidental dermoid cyst to assess ovarian reserve, recurrence of either of the cysts, and it also presents a challenge to clinicians to predict the post-operative course of such cases.

scholarly journals Hydatid Disease Simulating Acute Abdomen: A Case Report and Brief Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Georgios Lianos ◽  
Georgios Baltogiannis ◽  
Avrilios Lazaros ◽  
Konstantinos Vlachos
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Hydatid Disease ◽  
Acute Abdominal Pain ◽  
Abdominal Distension ◽  
The Body ◽  
Parasitic Disease ◽  
Review Of The Literature ◽  
Diffuse Abdominal Pain ◽  
Operating Surgeon

Introduction. Hydatid disease is caused by the tapewormEchinococcus granulosusand is still a matter of public health in many regions of the world, where it is an endemic parasitic disease. Although the liver is the most involved organ, hydatidosis can be found anywhere in the human body. Rare forms of location may lead to diagnostic and therapeutic dilemmas.Case Report. Herein we report a rare case of acute abdominal pain and progressively increasing abdominal distension due to abdominal and multiple splenic echinococcosis in a 72-year-old Caucasian male. We also provide a brief review of the literature.Conclusion. Although hydatid disease is found most often in the liver and lungs, rarely any organ of the body can be involved by this zoonosis. Though rare, the possibility of unusual location of echinococcosis must always be considered by the operating surgeon, when dealing with diffuse abdominal pain in endemic areas, because any misinterpretation may result in unfavorable outcomes.

Prelaparoscopic assessment of ovarian cysts in reproductive‐age women

1997 ◽  
Vol 6 (3) ◽  
pp. 157-167 ◽  
Author(s):  
S. Guerriero ◽  
S. Ajossa ◽  
V. Mais ◽  
M. Angiolucci ◽  
A. M. Paoletti ◽  
...  
Keyword(s):  
Reproductive Age ◽  
Ovarian Cysts ◽  
Reproductive Age Women

scholarly journals An unusual case of pediatric abdominal pain

CJEM ◽  
2011 ◽  
Vol 13 (02) ◽  
pp. 133-138 ◽  
Author(s):  
Lars P. Bjoernsen ◽  
M. Bruce Lindsay
Keyword(s):  
Abdominal Pain ◽  
Colonic Obstruction ◽  
Exploratory Laparotomy ◽  
Symptomatic Treatment ◽  
Systematic Evaluation ◽  
White Female ◽  
Symptomatic Therapy ◽  
Regional Lymph Nodes ◽  
Diffuse Abdominal Pain ◽  
Gastrografin Enema

ABSTRACTChronic and recurrent abdominal pains are common complaints in children and adolescents, but the evaluation in the emergency department (ED) can be challenging. We present a rare yet serious case of a 17-year-old white female who presented to the ED with a 2-day history of diffuse abdominal pain, nausea, and intractable vomiting. Abdominal examination and imaging, including computed tomography (CT), were negative during an episode 6 weeks previously. This was her fifth similar episode in a 2-month period, and she had been seen at three different hospitals and admitted on each occasion. Three days prior to presentation to our ED, she was seen at a gastroenterology clinic and diagnosed with irritable bowel syndrome and an ovarian cyst. Symptomatic therapy during the current presentation, with intravenous fluids, antiemetics, and parenteral narcotics, failed to alleviate her abdominal pain and vomiting. Emergent CT evaluation revealed a high-grade colonic obstruction with focal circumferential narrowing in the transverse colon and a lower gastrointestinal follow-through radiograph with Gastrografin enema showed a classic “apple-core” lesion. Colonic adenocarcinoma with positive regional lymph nodes was found during emergent exploratory laparotomy. Pediatric patients with recurrent, episodic abdominal pain should undergo systematic evaluation and symptomatic treatment. A previous negative workup should not dissuade emergency physicians from proceeding with a systematic and thorough evaluation of the pediatric patient presenting with abdominal pain and vomiting.

scholarly journals Expression Level of Cyclin-D1 between Endometriomas and Ovarian Carcinomes

2021 ◽  
Vol 21 (1) ◽  
pp. 59-65
Author(s):  
Alfun Dhiya An ◽  
Supriyatiningsih Supriyatiningsih
Keyword(s):  
Ovarian Carcinoma ◽  
Cyclin D1 ◽  
Reproductive Age ◽  
Research Subjects ◽  
Ovarian Endometriosis ◽  
Cross Sectional ◽  
Anova Test ◽  
Significant Difference ◽  
Poorly Differentiated ◽  
The Mean

Endometrioma on the ovaries is a benign gynecological disorder that is often found in women of reproductive age. The approach was made to the malignant transformation through the study of cyclin-D1 expression. This research aim to analyze differences in the level of Cyclin-D1 expression in ovarian endometriosis and ovarian carcinoma associated with the pathogenesis of endometrioma and ovarian carcinoma. Analytical observational study with cross sectional approach to cyclin-D1 expression between endometrioma and ovarian carcinoma with good and bad differentiation. The research subjects were 20 cases of endometrioma, each of the 20 cases of ovarian carcinoma were well and poorly differentiated. Statistical analysis using the ANOVA test on the level of cyclin-D1 expression between groups. The mean cyclin-D1 expression in endometrioma was 67.25. The mean of well-differentiated ovarian carcinoma was 132.41. The mean of poorly differentiated ovarian carcinoma was 128.83. Anova test resulted in a significant difference between the expression of cyclin-D1 endometrioma and ovarian carcinoma with good and bad differences (p = 0.00 0.05). There is a significant difference between endometrioma and ovarian carcinoma with good and bad differentiation. Endometrioma cyclin-D1 expression was lower than ovarian carcinoma with good and bad differentiation.

scholarly journals Endometrioma mimicking ovarian malignancy in a post-menopausal woman

2021 ◽  
Vol 10 (8) ◽  
pp. 3226
Author(s):  
Vijay Zutshi ◽  
Shreshtha Gupta ◽  
Charanjeet Ahluwalia ◽  
Monica R.
Keyword(s):  
Normal Serum ◽  
Reproductive Age ◽  
Ca 125 ◽  
Menopausal Woman ◽  
Ovarian Malignancy ◽  
Ovarian Endometriosis ◽  
Post Menopausal Woman ◽  
Estrogen Production ◽  
Malignant Ovarian Tumor ◽  
Post Menopausal

Endometriosis is an estrogen dependant disorder of reproductive-age women. It is uncommon after menopause, however, peripheral estrogen production may account for endometriosis in post-menopausal women. We reported a case of a 68 year old post-menopausal woman with an adnexal mass suspected malignant ovarian tumor on imaging and normal serum CA 125 levels. Total hysterectomy with bilateral salpingo-oophorectomy was done. The final histopathology revealed the diagnosis of ovarian endometriosis. Rarely, ovarian endometrioma can mimic ovarian malignancy in a post-menopausal woman.

scholarly journals Mysterious Gelly Belly: a Case Report of Pseudomyxoma Peritonei and Literature Review

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Literature Review ◽  
Pseudomyxoma Peritonei ◽  
Clinical Condition ◽  
Imaging Techniques ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Primary Site ◽  
Diffuse Abdominal Pain

Pseudomyxoma peritonei (PMP) is a rare clinical condition defined as extensive intraperitoneal spread of mucus associated with a variety of mucinous tumors. Although appendix has usually been implicated as the primary site, some reports found no cause. This case also describes a PMP with no identifiable primary site. A 52-year-old male presented with an abdominal distension evolving for 3 months associated with diffuse abdominal pain, imaging techniques objective intra peritoneal mucoid materials with septated ascites but it failed to identify the primary site. Exploratory laparotomy with Biopsy confirmed PMP but also failed to found the original site.

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