Priangga Muhammad Dwi, Maulana Adhitya Yudha, Budi Yasmine Syifa Nabila, Idhar Syauqi Maulana, Situmorang Herbert
Department of Obstetrics and Gynecology, Faculty of Medicine, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia.
Obstetric and Gynecology Resident, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
Case Rep Obstet Gynecol. 2025 Jun 25;2025:1739044. doi: 10.1155/crog/1739044. eCollection 2025.
Endometriotic cysts are common, but bilateral giant endometriosis cyst with asymptomatic cases are extremely rare. Rupture is also uncommon, yet when it occurs, it can mimic appendicitis or ectopic pregnancy due to peritoneal irritation, often requiring emergency intervention. A 25-year-old woman presented with nausea, vomiting, and an enlarging abdominal lump. Ultrasonography revealed bilateral ovarian cystic masses with ground glass appearances and free subhepatic fluid. Due to worsening symptoms despite initial resuscitation, emergency exploratory laparotomy was performed. Intraoperatively, a ruptured right ovarian cyst (20 × 15 × 15 cm) with extensive adhesions to the posterior uterus, rectum, and right ovarian fossa was identified, along with a left ovarian endometriotic cyst (12 × 10 × 10 cm). The patient underwent right salpingo-oophorectomy, left cystectomy, and ureterolysis. Histopathology confirmed endometriotic cysts. Rapid surgical intervention is crucial in ruptured cysts to minimize adhesion formation and preserve fertility. Postoperatively, continuous hormonal therapy, such as oral progesterone or an intrauterine device, is recommended to decrease recurrence.
子宫内膜异位囊肿很常见，但双侧巨大子宫内膜异位囊肿且无症状的病例极为罕见。破裂情况也不常见，然而一旦发生，由于腹膜刺激，它可能会酷似阑尾炎或异位妊娠，常常需要紧急干预。一名25岁女性出现恶心、呕吐及腹部肿块增大症状。超声检查显示双侧卵巢囊性肿块，呈磨砂玻璃样外观，肝下有游离液体。尽管初始复苏后症状仍恶化，遂进行了急诊剖腹探查术。术中发现一个破裂的右卵巢囊肿（20×15×15厘米），与子宫后壁、直肠及右卵巢窝有广泛粘连，同时还有一个左卵巢子宫内膜异位囊肿（12×10×10厘米）。患者接受了右侧输卵管卵巢切除术、左侧囊肿切除术及输尿管松解术。组织病理学确诊为子宫内膜异位囊肿。对于破裂囊肿，迅速进行手术干预对于减少粘连形成和保留生育能力至关重要。术后，建议采用持续激素治疗，如口服孕激素或放置宫内节育器，以降低复发率。
