Ng Irene A T, Wong Jolene S M, Wong Jermaine, Chia Claramae S, Ong Chin-Ann J
Department of Sarcoma, Peritoneal and Rare Tumours (SPRinT), Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore.
Raffles Institution, Singapore, Singapore.
J Surg Case Rep. 2021 Mar 29;2021(3):rjab070. doi: 10.1093/jscr/rjab070. eCollection 2021 Mar.
We present an unprecedented case of torsion of a large ovarian cyst following colonoscopy. A 43-year-old female was found to have a 20 × 13 × 19 cm pelviabdominal mass possibly arising from the right ovary. Endoscopic evaluation was performed prior to planned resection of the ovarian mass. The patient experienced progressive lower abdominal pain after the procedure with a computed topography finding of torsion. She underwent exploratory laparotomy, right salpingo-oophorectomy with intra-operative frozen section and omentectomy. Final histology revealed features of benign serous cystadenoma with extensive haemorrhagic infarction in keeping with torsion. To our knowledge, this is the first reported case of torsion of a large ovarian cyst after colonoscopy. We propose a postulated mechanism of this patient's ovarian torsion and urge clinicians to be cognizant of acute ovarian torsion as a cause of severe abdominal pain following endoscopy.
我们报告了一例结肠镜检查后发生大型卵巢囊肿扭转的罕见病例。一名43岁女性被发现盆腔腹部有一个20×13×19cm的肿块，可能起源于右侧卵巢。在计划切除卵巢肿块之前进行了内镜评估。术后患者出现进行性下腹痛，计算机断层扫描发现有扭转。她接受了剖腹探查、术中冰冻切片检查的右侧输卵管卵巢切除术和大网膜切除术。最终组织学检查显示为良性浆液性囊腺瘤特征，伴有广泛出血性梗死，符合扭转表现。据我们所知，这是第一例报道的结肠镜检查后大型卵巢囊肿扭转病例。我们提出了该患者卵巢扭转的一种假定机制，并敦促临床医生认识到急性卵巢扭转是内镜检查后严重腹痛的一个原因。
