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]
Entire Body System
- Fever
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]
She denied fevers, chills, dysuria, vaginal bleeding, discharge, or diarrhea. The physical examination was notable for blood pressure of 152/92 mmHg and BMI of 43.9. [link.springer.com]
+/-Fever. Treatment: Excision or may be left in situ. [5] Gross Black/blue ovary. [4] Microscopic Features: Necrosis of ovarian parenchyma. Lack of significant nuclear atypia. Note: Microscopy is nonspecific. [librepathology.org]
Physical examination should include vital signs, which can show tachycardia, hypertension, hypotension, or even fever. [emdocs.net]
See your doctor right away if you have these symptoms: Sudden, severe belly pain Pain with fever and throwing up Dizziness, weakness, feeling faint Fast breathing These signs could mean your cyst has caused the ovary to twist. [webmd.com]
- Severe Pain
When an ovary twists, women have sudden, severe pain in the pelvic area. The pain is sometimes accompanied by nausea and vomiting. Before the sudden pain, women may have intermittent, crampy pain for days or occasionally even for weeks. [merckmanuals.com]
While most ovarian cysts are small and go unnoticed, others may cause a range of symptoms -- from mild discomfort to severe pain. [livestrong.com]
There was no history of fever, bleeding per vagina or per rectum, previous surgeries, discharge per vagina or bladder disturbances.Patient was conscious, oriented and in severe pain .On abdominal examination there was distension with a tense, tender, [panafrican-med-journal.com]
Pain relievers : Anti-inflammatory medication such as ibuprofen (for example, Advil) may help reduce pelvic pain. Narcotic pain medications by prescription may relieve severe pain caused by ovarian cysts. [emedicinehealth.com]
- Disability
Please enable JS and disable any ad blocker [livre.fnac.com]
- Pathologist
The concordance between the two pathologist OPS data sets was analysed by the Cohen’s Kappa -test statistic. All analyses were performed in SPSS v20 (IBM, Inc. US). [oatext.com]
Delayed treatment may be associated with tissue infarction and necrosis, which may be misleading for the pathologist. In some cases, delayed diagnosis leads to intra-peritoneal hemorrhage, which is a life-threatening condition (6). [jmrh.mums.ac.ir]
- Surgical Procedure
Laparoscopic or open surgical detorsion with preservation of viable functional ovarian tissue, oophorectomy or salpingectomy with contralateral oopheropexy if torsion is idiopathic in nature are the surgical procedures offered. [sonoworld.com]
Gastrointestinal
- 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]
The preferred modality of imaging in the female with pelvic and abdominal pain is ultrasound with the use of Doppler flow studies to aid in the diagnosis of ovarian torsion. [emdocs.net]
Any female patient who presents with abdominal pain should prompt consideration of torsion in ED providers. [epmonthly.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
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]
[…] are among the most common abdominal masses in female fetuses [2, 3]. [degruyter.com]
It is estimated that 5% of all abdominal masses in the first month of life are ovarian cysts. [clevelandclinicmeded.com]
- Abdominal Distension
distension, change in appetite, pelvic pain, urinary urgency). [racgp.org.au]
distension Bloating Feeling of abdominal fullness Heartburn Indigestion Feeling full early when eating Problems with the control of urination A ruptured ovarian cyst typically causes severe pain that comes on suddenly. [emedicinehealth.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]
Musculoskeletal
- Low Back Pain
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]
Urogenital
- 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]
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]
But a large ovarian cyst can cause: Pelvic pain that may come and go. You may feel a dull ache or a sharp pain in the area below your bellybutton toward one side. Fullness, pressure or heaviness in your belly (abdomen). Bloating. [mayoclinic.org]
Ultrasound is a commonly used imaging modality in evaluating acute pelvic pain; cystic etiologies of torsion are easily visualized [ 3, 4 ]. [link.springer.com]
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]
- Adnexal Mass
View Article PubMed Google Scholar Duic Z, Kukura V, Ciglar S, et al: Adnexal masses in pregnancy: a review of eight cases undergoing surgical management. Eur J Gynaecol Oncol. 2002, 23: 133-134. PubMed Google Scholar Hibbard LT: Adnexal torsion. [casesjournal.biomedcentral.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]
Among 44 postmenopausal patients with acute pelvic masses, 10 cases with adnexal torsion were selected. The exclusion criteria were adnexal masses without torsion, non-menopausal status and inadequate data. [jmrh.mums.ac.ir]
Definition Ovarian cysts, also known as ovarian masses or adnexal masses, are frequently found incidentally in asymptomatic women. [clevelandclinicmeded.com]
The affected ovary may show a heterogeneous echotexture and may be seen as a complex adnexal mass with septations and debris, as a cystic mass or as a solid mass with peripheral cysts. 3. [sonoworld.com]
- Adnexal Tenderness
Physical examination may reveal lower abdominal tenderness. On pelvic exam, the patient may have adnexal tenderness or an adnexal mass. Fever is uncommon, and usually low-grade if present. [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
[…] hemorrhagic cyst, symptoms of ovarian cysts, cyst in ovary, polycystic ovarian disease, ovarian cyst treatment, ovarian pain, ovarian, pain in ovaries, ovarian cysts symptoms, abnormal vaginal bleeding, dermoid ovarian cyst, ovaries hurt, complex ovarian [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]
Ultrasound
- Ovarian Mass
Ovarian masses or cysts are very common and 10% of women have an operation during their life for investigation of an ovarian mass. 1 These masses are typically found in asymptomatic women who have imaging for another reason, or for investigation of non-specific [racgp.org.au]
Examination of the abdominal right lower quadrant revealed tenderness and a solid mass. Ultrasonography showed the dimensions of the mass 75x51x40 mm in the right ovarian lodge and a locular cystic mass measuring 44x25mm in the left ovarian lodge. [jpss.eu]
The patient showed a voluminous mass situated in the abdomen and noncontiguous to the uterus by ultrasound scan. Laparotomy confirmed the diagnosis of cystic ovarian mass with torsion of uterus. [panafrican-med-journal.com]
If on surgical examination the ovarian tissue is obviously necrotic, it may be removed. An ovarian mass or cyst may be resected. Most surgeons will try to salvage any normal ovarian tissue in a premenopausal patient. [cdemcurriculum.com]
Moreover, risk of OT increases in postmenopausal women with ovarian masses (1). [jmrh.mums.ac.ir]
Treatment
Treatment of ovarian cysts If you have an ovarian cyst, you may not need any treatment. [bupa.co.uk]
Cause #2: Fertility Treatment Tayra Lucero for LittleThings There are lots of different fertility treatments out there, but many of the common treatments focus on stimulating the ovarian follicle with hormones to produce an egg. [littlethings.com]
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]
Continued What Is the Treatment? Most cysts need no treatment. They go away on their own. If a cyst is large or causes problems, then your doctor may want to watch it. That means you don’t do anything right away. She’ll check it again later. [webmd.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]
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]
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]
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]
Etiology and pathophysiology Ovarian torsion is the total or partial rotation of the adnexa around its vascular axis. [mdmag.com]
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. Signs and Symptoms (“What symptoms will my child have?”) [eapsa.org]
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]
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]
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]
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]
If a conservative procedure is performed at the time of surgery, then measures to prevent a future torsion can be undertaken. [walnuthillobgyn.com]