WANDERING OVARYWANDERING OVARYDR. J.CHITRA M.D , DGO, D.NB DR. J.CHITRA M.D , DGO, D.NB
ASST PROFESSOR ASST PROFESSOR KANYAKUMARI GOVT KANYAKUMARI GOVT
MEDICAL COLLEGEMEDICAL COLLEGE
Clinical historyClinical historyo 24 years old young unmarried girl 24 years old young unmarried girl o Acute abdominal pain for 4 days Acute abdominal pain for 4 days o Attained menarche 14Attained menarche 14thth year year o Periods once in 2 months / 3 days Periods once in 2 months / 3 days o Painless, scanty periodsPainless, scanty periods
Previous historyPrevious history 1 year back, was treated for the 1 year back, was treated for the
same acute abdominal pain same acute abdominal pain elsewhere. elsewhere.
Diagnosed as bilateral Diagnosed as bilateral multiloculated ovarian cysts multiloculated ovarian cysts
Advised surgery- she refused Advised surgery- she refused Treated conservatively Treated conservatively She was symptom free for one yearShe was symptom free for one year
Scan report Scan report Scan taken on 5.10.04 Scan taken on 5.10.04 Rt.Ovary 12x12cm Rt.Ovary 12x12cm
Cystic, multilocular, Cystic, multilocular, thin walled thin walled
Lt Ovary 11x12 cm, Lt Ovary 11x12 cm, cysticcystic
CLINICAL EXAMINATIONCLINICAL EXAMINATION O/E - P/A no mass palpable O/E - P/A no mass palpable P/R - Cystic, tender mass felt occupying the pouch P/R - Cystic, tender mass felt occupying the pouch
ofof DouglasDouglas
Routine investigations normal Routine investigations normal UltrasonagrUltrasonagr
am am
right ovarian cyst –multi loculated 12 right ovarian cyst –multi loculated 12 x 12 cm x 12 cm Left ovary –not visualized Left ovary –not visualized
Uterus normalUterus normal
LAPAROSCOPY FINDINGSLAPAROSCOPY FINDINGS Right Ovary Right Ovary Twisted Twisted Cystic, Multilocular Cystic, Multilocular Variable in size Variable in size Thin walled Thin walled
Procedure on Right Procedure on Right ovarian cystovarian cyst
Untwisting of the Untwisting of the ovarian cyst done ovarian cyst done
Cystectomy done Cystectomy done Remaining ovarian Remaining ovarian
tissue left outtissue left out
LEFT OVARY NOT SEEN AT ITS SITE
Amputated site of left ovary
ATTACHED TO OMENTUMOVARY
WANDERING OVARYWANDERING OVARY
Normal looking ovary ,3.5 cm x 3 cm Normal looking ovary ,3.5 cm x 3 cm x 2 cm in size, seen attached to x 2 cm in size, seen attached to omentum omentum
Feeding vessels are seen from Feeding vessels are seen from omentumomentum
Procedure on Right Procedure on Right ovarian cystovarian cyst
Untwisting of the Untwisting of the ovarian cyst done ovarian cyst done
Cystectomy done Cystectomy done Remaining ovarian Remaining ovarian
tissue left outtissue left outLEFT OVARY NOT SEEN AT ITS SITE
HPE SIMPLE SEROUS CYST RIGHT HPE SIMPLE SEROUS CYST RIGHT OVARIAN CYSTOVARIAN CYST
AMPUTED OVARIAN BIOPSY AMPUTED OVARIAN BIOPSY CONFIRMED OVARIAN TISSUE – HPECONFIRMED OVARIAN TISSUE – HPE
FOLLOW UP REGULAR
MENSTRUATIONSTARTED AFTER THREE MONTHS
AFTER ONE YEAR ULTRA SOUNDREVEALED NORMAL UTERUS. RIGHT OVARY 4 x 3cms LEFT OVARY NOT SEEN
NO OTHER CYSTIC MASS SEENPLAIN X-RAY – NO CALCIFICATION NOTED
THANK YOU
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