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Complications Of Ovarian Cyst


Ovarian Cyst: Complications- Details on Torsion Of Ovarian Cyst

Ovarian Cysts are ono-neoplastic enlargement of Ovaries with accumulation of fluid inside the functional unit of Ovary. Cysts may be functional or Non-functional.  The Complications of Ovarian Cyst are:

  • Infection
  • Intracystic Hemorrhage
  • Rupture
  • Pseudomyxoma peritonei
  • Malignancy- Cancer
  • Torsion of the Pedicle.
  • Torsion Of Ovarian Pedicle or Twisted Ovarian Cyst:

    Among the complications of these Ovarian cysts, Torsion of ovarian pedicle may cause the patient to present in Emergency in Acute painful condition and in Distress. Although it is often referred as Torsion of Cyst, actually it is the torsion of the cyst pedicle.
    Torsions are more common in Serous Cysadenomas  and dermoid cysts. Axial rotations are seen in 10-15% cases at OT.

    twisted ovarian cyst Complications Of Ovarian Cyst

    Twisted ovarian cust

    The Structures Forming Pedicle for Torsion are:

    • Laterally – Infundibulopelvic ligament containing ovarian vessels, nerves and lymphatics
    • Medially- Ovarian ligament, Medial end of Fallopian tube, Mesosalpinx
    • Middle- Broad Ligament

    Causes – Etiology of torsion of Pedicle is obscure.

    Predisposing factors are: -

    1. Trauma
    2. Violent Physical movements
    3. Contraction Of Pregnant Uterus
    4. Intestinal peristalsis

    Precipitating Factors:- Hemodynamic theory suggests that  slight axial rotation that leads to venous occlusion causes cyst to rotate with each arterial pulsation. It may get untwisted spontaneously or  few cases cyst may rupture and cause crisis situation.

    Symptoms:-

    • Varies with severity.
    • In completely occluded cases, severe pain is the complaint.
    • Lump may be feltper abdomen.
    • Patient is in agony but general condtion is fair.
    • Abdominal tenderness +, tense cystic mass, restricted mobility, usually in hypogastrium and arising from pelvis
    • Pelvic examination reveals that the mass is separate from the uterus.

    Differential Diagnosis:

    1. Disturbed Ectopic gestation
    2. Acute Hydramnios
    3. Perforating mole
    4. Torsion of Fibroid

    Treatment:

    Supress pain with Morphine 15mg IM

    Laparotomy followed by Salpingoophorectomy ( Ovariotomy)

    ovarian cyst Complications Of Ovarian Cyst

    Ovarian Cyst

    Source: DC Dutta Gynecology.

    Tags: Acute Hydramnios Perforating mole, dermoid cyst, Ectopic gestation, ovarian cyst, ovariotomy, salpingoopherectomy, torsion, Torsion of Fibroid, twisted ovarian cyst


    Last updated: June 26, 2010



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