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Ovarian Cyst Torsion

Cysts Ovarian Torsion


Presentation

  • We presented a case of acute ovarian cyst torsion in a 2-year-old girl who originally presented to the emergency department with abdominal pain and vomiting. Ultimately, she was found to have a 2-cm cyst of the right ovary with concomitant torsion.[ncbi.nlm.nih.gov]
  • The majority of the cases presented in pregnant (22.7%) than in non-pregnant (6.1%) women[ 2 ].[casesjournal.biomedcentral.com]
  • Moses Mhayamaguru Edward Haynes Bruno Suzanne Michelle Rhodes Richard Amini CE - MEDICAL ILLUSTRATION First Online: 16 August 2016 Patient presentation A 20-year-old, otherwise healthy, G1P1 woman presents to the emergency department complaining of sudden[link.springer.com]
Cough
  • […] mechanisms including tortuosity and elongation of the tube or mesosalpingeal vessels, incomplete mesosalpinx, an overly active ovary, congenitally long supportive ligaments, tubal spasm or abrupt changes in intra-abdominal pressure with vomiting or coughing[jpss.eu]
Abdominal Pain
  • It is important to keep ovarian torsion in the differential of any female children with acute abdominal pain.[ncbi.nlm.nih.gov]
  • The presentation of ovarian torsion classically includes acute onset lower abdominal pain and a palpable adnexal mass; nausea and vomiting occur in 70 % of patients [ 3 ].[link.springer.com]
  • We report a case of a patient with acute abdominal pain. The patient showed a voluminous mass situated in the abdomen and noncontiguous to the uterus by ultrasound scan.[panafrican-med-journal.com]
  • A 7-year old girl was admitted with complaints of abdominal pain and vomiting. Examination of the abdominal right lower quadrant revealed tenderness and a mass with dimensions of 7cm.[jpss.eu]
  • Ovarian cyst: Abdominal pain Sharp, unilateral Intermittent vs. constant Migration Previous episodes May occur with exercise, intercourse, trauma, or pelvic exam Fever is r...[5minuteconsult.com]
Lower Abdominal Pain
  • The presentation of ovarian torsion classically includes acute onset lower abdominal pain and a palpable adnexal mass; nausea and vomiting occur in 70 % of patients [ 3 ].[link.springer.com]
  • Torsion of the ovary and or fallopian tube is responsible for between 3-8% of all gynaecological emergencies women present with sudden onset acute lower abdominal pain, sometimes central or on either side of the lower abdomen depending on which ovary[ukgynaecologist.com]
  • The patients present with acute onset lower abdominal pain, nausea and vomiting. Clinically it mimics a number of conditions, the closest differential being appendicitis.[sonoworld.com]
  • A woman typically presents either to her physician or to the emergency room with sudden onset of lower abdominal pain. Pain often coincides with heavy lifting, exercise, or intercourse.[walnuthillobgyn.com]
Abdominal Mass
  • […] are among the most common abdominal masses in female fetuses [2, 3].[degruyter.com]
  • Commonly presents with abdominal pain, nausea, vomiting, and an abdominal mass. High clinical suspicion is necessary. Clinical presentation is non-specific, with no absolute clinical profile.[bestpractice.bmj.com]
  • It is estimated that 5% of all abdominal masses in the first month of life are ovarian cysts.[clevelandclinicmeded.com]
Left Lower Quadrant Pain
  • They are more likely to present with fever and diffuse pain, rather than focused right or left lower quadrant pain. The most common presenting symptom is pelvic pain followed by the history of or a palpable adnexal mass on physical exam.[emdocs.net]
Severe Abdominal Pain
  • They can also cause the ovary to twist on a stalk (a condition known as ovarian torsion), compromising the blood supply and causing severe abdominal pain .[emedicinehealth.com]
Jaundice
  • Poisoning 792 Pancreatic Trauma 794 Multiple Myeloma 798 Parkinson Disease 802 Munchausen Syndrome 804 Myocardial Contusion 810 Neck Injury by StrangulationHanging 818 Penile Shaft Fracture 820 Sting 822 Necrotizing Soft Tissue Infections 824 Neonatal Jaundice[books.google.de]
Adnexal Mass
  • Diagnosis can usually be made on the basis of the characteristic clinical presentation in conjunction with ultrasound evidence of a unilaterally enlarged adnexal mass.[casesjournal.biomedcentral.com]
  • The presentation of ovarian torsion classically includes acute onset lower abdominal pain and a palpable adnexal mass; nausea and vomiting occur in 70 % of patients [ 3 ].[link.springer.com]
  • Important questions regarding medical history include the presence of adnexal mass, gynecologic or obstetric diseases, pregnancy, ongoing infertility treatment, and prior adnexal mass.[emdocs.net]
  • The leading causes are the presence of leiomyomas or, rarely, adnexal masses. In this report a 55-year old patient presented with acute abdominal pain.[panafrican-med-journal.com]
  • Two distinct age groups are identified, the prepubertal or the adolescent age group, where it is mainly idiopathic in nature and in the postmenopausal group due to adnexal masses.[sonoworld.com]
Pelvic Pain
  • At 14 years of age, she received salpingo-oophorectomy because of ovarian cyst torsion presenting as acute pelvic pain.[ncbi.nlm.nih.gov]
  • Ultrasound is a commonly used imaging modality in evaluating acute pelvic pain; cystic etiologies of torsion are easily visualized [ 3 , 4 ].[link.springer.com]
  • In a patient with an adnexal mass, acute pelvic pain, and ultrasound findings consistent with torsion, the diagnosis can be presumed.[emdocs.net]
  • This may be intermittent, or can be severe, sudden, and sharp Irregular menstrual periods A feeling of lower abdominal or pelvic pressure or fullness Chronic pelvic pain or low back pain throughout the menstrual cycle Pelvic pain following exercise or[emedicinehealth.com]
  • In these cases, you may have: pelvic pain – this can range from a dull, heavy sensation to a sudden, severe and sharp pain pain during sex difficulty emptying your bowels a frequent need to urinate heavy periods, irregular periods or lighter periods than[nhs.uk]
Adnexal Tenderness
  • On pelvic exam, the patient may have adnexal tenderness or an adnexal mass. Fever is uncommon, and usually low-grade if present. Diagnostic Testing The most dangerous condition in the differential for adnexal torsion is an ectopic pregnancy.[cdemcurriculum.com]
  • One study of emergency department physicians found an inter-examiner reliability of only 23% for detection of pelvic masses, and only 32% for the presence of adnexal tenderness ( Close, 2001 ).[emlyceum.com]
Dyspareunia
  • This is often shortly before the menstrual cycle or slightly after, and can also be present during intercourse (called dyspareunia). Pain or pressure on bowels during bowel movements.[reverehealth.com]
  • She was in a two year monogamous relationship, did not experience any dyspareunia and denied any prior sexually transmitted diseases. Her cervical smears were up to date and had been consistently reported as normal.[amsj.org]
Ovarian Pain
  • pain, ovarian, pain in ovaries, ovarian cysts symptoms, abnormal vaginal bleeding, dermoid ovarian cyst, ovaries hurt, complex ovarian cyst, signs of ovarian cysts, ovarian cyst removal, what causes ovarian cysts, hemorrhagic ovarian cyst,[pinterest.de]

Workup

  • Discussion The workup demonstrated a negative pregnancy test and a mildly elevated AST/ALT.[link.springer.com]
  • To minimize the risk of missing a case of ovarian torsion, we’ll cover several important pitfalls and misconceptions related to the workup of potential torsion.[epmonthly.com]
  • […] to and treatment by gynecologic oncologists has been shown to improve survival rates in women with ovarian cancer. 14-16 Cysts with an Indeterminate Likelihood of Malignancy For women with cysts with an intermediate likelihood of malignancy, further workup[clevelandclinicmeded.com]
Colonic Stricture
  • The left fimbria and ovary swirled around the sigmoid colon, causing colonic stricture. Intestinal obstruction Ovarian cyst Torsion Colonic stricture This is a preview of subscription content, log in to check access.[springerlink.com]
Urethral Displacement
  • Specific clinical signs including vaginal bleeding, uterine tenderness, a twisted vaginal canal and urethral displacement have been reported.[panafrican-med-journal.com]
Ovarian Mass
  • Surgical management of the incidentally identified ovarian mass. Seminars in Pediatr Surg 2005;14:106-10.[jpss.eu]
  • Laparotomy confirmed the diagnosis of cystic ovarian mass with torsion of uterus. Introduction Uterine torsion is a rare condition in the nongravid uterus[ 1 ].[panafrican-med-journal.com]
  • Melissa Yeoh Background Ovarian masses are very common in pre- and postmenopausal women and are typically an incidental finding.[racgp.org.au]
  • Abstract Owing to the improvement in obstetric ultrasound imaging, prenatal diagnosis of ovarian masses has increased considerably.[degruyter.com]
  • An ovarian mass or cyst may be resected. Most surgeons will try to salvage any normal ovarian tissue in a premenopausal patient.[cdemcurriculum.com]

Treatment

  • However Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 61 participants Allocation: Randomized Intervention Model: Single Group Assignment Masking: None (Open Label) Primary Purpose: Treatment Official[clinicaltrials.gov]
  • For surgery has to be resorted to only when a large blood loss and failure of medical treatment. Torsion ovarian cyst. To the development of torsion of the cyst leads anatomical feature of the ovary.[allcysts.com]
  • Treatment of ovarian cysts If you have an ovarian cyst, you may not need any treatment.[bupa.co.uk]
  • Other symptoms of AOT which include anorexia, nausea, vomiting, low-grade fever and urinary complaints are unfortunately neither sensitive nor specific and often lead to delay in diagnosis and treatment.[jpss.eu]
  • TODAY'S EVENTS Calendar - Hysterectomies - Birthdays Request Information Fibroid Treatments Post-op Intimacy - Weight Loss …more I am a HysterSister HYSTERECTOMY STORIES Featured Story - All Stories - Share Yours FOLLOW US Your Hysterectomy Date CUSTOMIZE[hystersisters.com]

Prognosis

  • For this reason, the clinical course, prognosis, and mortality rates associated with torsion of a nongravid uterus are not well documented. Uterine torsion is difficult to diagnose preoperatively [ 5 ].[panafrican-med-journal.com]
  • Management and ovarian prognosis: a report of 45 cases. J Pediatr Surg. 2009;44: 1759–65. Web of Science Crossref Google Scholar [9] Hadlock FP, Harrist RB, Sharman RS, Deter RL, Park SK.[degruyter.com]
  • Although ovarian torsion in very young children is rare, a case of ovarian cyst torsion was reported in a 2-year-old. [17] Prognosis With early diagnosis and appropriate treatment, the prognosis of ovarian torsion is excellent.[emedicine.medscape.com]
  • What Is the Prognosis for a Female with Ovarian Cyst(s)? The outlook for a woman with an ovarian cyst depends on the type and size of cyst, as well as her age. Noncancerous (benign) masses or cysts greatly outnumber cancerous (malignant) ones.[emedicinehealth.com]
  • For epithelial tumors - by far the most common group of malignant ovarian tumors - even after surgery, the exact tumor subtype is much less important for the prognosis than factors such as FIGO-stage, tumor differentation grade, and how succesful surgery[radiologyassistant.nl]

Etiology

  • Ultrasound is a commonly used imaging modality in evaluating acute pelvic pain; cystic etiologies of torsion are easily visualized [ 3 , 4 ].[link.springer.com]
  • The etiology of fetal ovarian cysts is still unknown, although a linkage with fetal gonadotrophin stimulation derived from maternal estrogens or placental human chorionic gonadotrophin (hCG) has been suggested.[degruyter.com]
  • The exact etiology is obscure. Most commonly seen are dermoid and serous cystadenomas. Complete torsion causes venous and lymphatic blockade leading to stasis and venous congestion, haemorrhage and necrosis. The cyst becomes tense and may rupture.[casesjournal.biomedcentral.com]
  • Etiology and pathophysiology Ovarian torsion is the total or partial rotation of the adnexa around its vascular axis.[mdmag.com]

Epidemiology

  • Epidemiology: Ovarian torsion is the fifth most common emergency of the female reproductive organs. Etiology (cause): Sometimes a mass or cyst in the ovary can cause twisting. If the stalk of the ovary is long, it may also lead to torsion.[eapsa.org]
  • Risk factors for benign, borderline and invasive mucinous ovarian tumors: epidemiological evidence of a neoplastic continuum? Gynecol Oncol 2007; 107:223–230.[clevelandclinicmeded.com]
  • In these cases the ovary must be surgically removed. [13] [14] Epidemiology [ edit ] Ovarian torsion accounts for about 3% of gynecologic emergencies.[en.wikipedia.org]
  • Epidemiology The true incidence of ovarian torsion is unknown.[emdocs.net]
  • Epidemiology Studies reveal that ovarian torsion is the fifth most common gynecologic surgical emergency, accounting for 2.7% of cases of acute gynecologic complaints in 1 series.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Removal of benign cysts does not decrease future mortality from ovarian cancer. 1,3-5 Back to Top Pathophysiology Provided below is a brief description of the pathophysiology of various types of physiologic and neoplastic ovarian cysts and the potential[clevelandclinicmeded.com]
  • […] of reproductive age, it can occur at any age. [2] Signs and symptoms [ edit ] Patients with ovarian torsion often present with sudden onset of sharp and usually unilateral lower abdominal pain, in 70% of cases accompanied by nausea and vomiting. [6] Pathophysiology[en.wikipedia.org]
  • The explanation for this discrepancy lies in the pathophysiology of torsion and in ovarian anatomy.[emlyceum.com]
  • Etiology and pathophysiology Ovarian torsion is the total or partial rotation of the adnexa around its vascular axis.[mdmag.com]
  • […] ovary and can help in determining whether blood flow is impaired. [9, 10, 11] In a patient with a history and physical examination findings suggestive of ovarian torsion, gynecologic consultation and subsequent laparoscopy are critical. [12, 13, 14] Pathophysiology[emedicine.medscape.com]

Prevention

  • Because acute ovarian torsion in a very young child is not encountered frequently, timely diagnosis is required to prevent mortality and minimize morbidity.[ncbi.nlm.nih.gov]
  • Posted : September 22, 2005 Last Update Posted : February 3, 2010 Sponsor: Information provided by: University Hospital, Tours Brief Summary: The purpose of this study is to determine whether prenatal ovarian cyst aspiration is effective and safe to prevent[clinicaltrials.gov]
  • Early diagnosis and prompt surgery may prevent irreversible adnexal damage by untwisting the vascular pedicle and removing an associated cyst or tumor, if present [15,16].[jpss.eu]
  • The complete absence of flow should be confirmed by power Doppler to prevent erroneous interpretation. 3. In cases of partial/incomplete torsion, intra-ovarian flow may be demonstrated.[sonoworld.com]
  • However, if the ovary doesn't spring back to life, you'll need surgery to remove it to prevent infection. But even then, as long as your other ovary is still working, infertility should not be an issue.[prevention.com]

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