Chauhan Subodhsingh, Blacker Charla
Center of Reproductive Medicine, Dept of Obstetrics and Gynecology, West Virginia University School of Medicine, Charleston Division, USA.
W V Med J. 2005 Jul-Aug;101(4):176.
Paratubal cyst can undergo torsion that can make it difficult to diagnose since tubal cysts mimic ovarian cysts. Most reported cases of paratubal cysts have occurred in pediatric patients, and this type of cyst rarely causes symptoms of lower abdominal pain mimicking appendicitis. We present the case of a 28-year-old female who was taking Carbergoline for hyperprolactinoma associated with a pituitary adenoma who came to the ER at Henry Ford Hospital in Detroit experiencing severe abdominal pain. Her pain was not accompanied by nausea, vomiting or other gastrointestinal symptoms. A transvaginal ultrasound revealed a normal uterus with the right ovary containing a cyst measuring 3 cm. x 2 cm. She was released on analgesics and seen at the clinic at Henry Ford Hospital three days later. She was still experiencing pain and was given antibiotics and Darvocet. When the pain had not subsided 48 hours later, a decision was made to perform diagnostic laparoscopy. Surgery was performed 10 days later and a paratubal cyst was removed that was twisted twice on its pedicle. This case illustrates the fact that torsion of paratubal cyst should be included in the differential diagnosis of adnexal pain.
输卵管旁囊肿可发生扭转，由于输卵管囊肿与卵巢囊肿相似，这可能导致诊断困难。大多数报道的输卵管旁囊肿病例发生在儿科患者中，这种囊肿很少引起类似阑尾炎的下腹部疼痛症状。我们报告一例28岁女性病例，该女性因垂体腺瘤相关的高泌乳素血症正在服用卡麦角林，她前往底特律亨利福特医院急诊室，主诉严重腹痛。她的疼痛未伴有恶心、呕吐或其他胃肠道症状。经阴道超声检查显示子宫正常，右侧卵巢有一个3厘米×2厘米的囊肿。她在服用镇痛药后出院，并于三天后到亨利福特医院门诊就诊。她仍感到疼痛，于是给予抗生素和达沃西特（一种镇痛药）。48小时后疼痛仍未缓解，决定进行诊断性腹腔镜检查。10天后进行了手术，切除了一个输卵管旁囊肿，该囊肿在其蒂部扭转了两次。该病例表明，输卵管旁囊肿扭转应纳入附件疼痛的鉴别诊断。
