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Answer to the case of the week # 530

January 21st, 2021 - February 11th, 2021

Dr. P. Turnova1, Dr. K. Biringer1,  Dr. N. Visnovcova2, Dr. M. Zibolen3

1.Department of Obstetrics and Gynecology, Martin University Hospital , Slovakia

2.Department of Pediatric Surgery, Martin University Hospital , Slovakia

3.Department of Neonatology, Martin University Hospital, Slovakia

 Email: petraturnova@hotmail.com

 

A 31 year-old G2P1 was referred to our department at 37 weeks of her pregnancy due to cystic abdominal mass. Her previous ultrasound examinations at 12 , 20 and 30 weeks were reported to be normal and the course of the pregnancy was uneventful. 

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Our ultrasound examination revealed a heterogeneus mass located in the left side of the pelvis and abdomen suggestive of ovarian cyst hemorrhage and torsion. The fetus had no tachycardia and MCA PSV was normal. The baby was born at 38 weeks of pregnancy. The surgery was performed at day 5 and the diagnosis ovarian cyst torsion was confirmed. 



Image 1,2 showing the mass in the left side of the pelvis and abdomen. 



Image 3 showing multifollicular enlargement caused by transudation of fluid into the follicles secondary to congestion in torsion. Small amount of free fluid is noted adjacent to the cyst suggesting the peritoneal irritation.

(Sorry the video can't be shown since flash player is no longer supported by the engine of thefetus.net... We are waiting for the engine update which should enable .mp4 videos display...)

 

Images 4 and 5: The postnatal surgery confirmed the brown color cystic mass with twisted peduncle and peri-cystic adhesions. The left ovary and the tube were necrotic and were removed. 


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