Successful laparoscopy management of 20cm mass that caused 1260 degrees rotation of adnexa in first trimester of pregnancy: a case report and literature review
Abstract
Diagnosing and managing pelvic pain during pregnancy is often challenging. This pain can be obstetrical, gynecological, or non-obstetrical_non-gynecological. Ovarian torsion, known as the consequence of ovarian twisting on its supporting ligaments, is one of the causes of gynecological pelvic pain that can occur during pregnancy and cause emergencies. However, early detection can preserve the ovaries and preserve the patient's current and future fertility. Surgery is the gold standard for the diagnosis and treatment of ovarian torsion. It is important to choose the best surgical technique (laparoscopy or laparotomy) to reduce possible complications during and after surgery. Our case is a 7-8 weeks pregnant woman who underwent laparoscopic surgery with an ovarian mass of 85*152 mm and an acute abdomen. It was found that the mass has caused 1260 degrees rotation in the patient's left adnexa. The results during and after surgery, as well as the condition of the mother and baby, were favorable.
[2] Bozzo M, Buscaglia M, Ferrazzi E. The management of persistent adnexal masses in pregnancy. American journal of obstetrics and gynecology.1997; 177(4):981-2. [DOI:10.1016/S0002-9378(97)70315- 6][PMID]
[3] George PE, Shwaartz C, Divino CM. Laparoscopic surgery in pregnan- cy. World Journal of Obstetrics and Gynecology. 2016; 5(2):175-81. [DOI:10.5317/wjog.v5.i2.175]
[4] Huchon C, Fauconnier A. Adnexal torsion: A literature review. Euro- pean Journal of Obstetrics & Gynecology and Reproductive Biology. 2010; 150(1):8-12. [DOI:10.1016/j.ejogrb.2010.02.006] [PMID]
[5] Ssi-Yan-Kai G, Rivain AL, Trichot C, Morcelet MC, Prevot S, Deffieux X, et al. What every radiologist should know about adnexal torsion. Emergency Radiology. 2018; 25(1):51-9. [DOI:10.1007/s10140-017- 1549-8] [PMID]
[6] Hasson J, Tsafrir Z, Azem F, Bar-On S, Almog B, Mashiach R, et al. Comparison of adnexal torsion between pregnant and nonpregnant women. American Journal of Obstetrics and Gynecology. 2010; 202(6):536-e1-e6. [DOI:10.1016/j.ajog.2009.11.028] [PMID]
[7] Robert L, Giuntoli II, Vang RS, Bristow RE. Evaluation and man- agement of adnexal masses during pregnancy. Clinical Obstetrics And Gynecology. 2006; 49(3):492-505. [DOI:10.1097/00003081- 200609000-00009] [PMID]
[8] Schmeler KM, Mayo-Smith WW, Peipert JF, Weitzen S, Manuel MD, Gordinier ME. Adnexal masses in pregnancy: Surgery compared with observation. Obstetrics & Gynecology. 2005; 105(5):1098-103. [DOI:10.1097/01.AOG.0000157465.99639.e5] [PMID]
[9] Yen CF, Lin SL, Murk W, Wang CJ, Lee CL, Soong YK, et al. Risk analy- sis of torsion and malignancy for adnexal masses during pregnancy. Fertility and Sterility. 2009; 91(5):1895-902. [DOI:10.1016/j.fertns- tert.2008.02.014] [PMID]
[10] Whitecar P, Turner S, Higby K. Adnexal masses in pregnancy: A review of 130 cases undergoing surgical management. Ameri- can Journal of Obstetrics and Gynecology. 1999; 181(1):19-24. [DOI:10.1016/S0002-9378(99)70429-1] [PMID]
[11] Choi JJ, Mustafa R, Lynn ET, Divino CM. Appendectomy during pregnancy: Follow-up of progeny. Journal of the American Col- lege of Surgeons. 2011; 213(5):627-32. [DOI:10.1016/j.jamcoll- surg.2011.07.016] [PMID]
[12] Soriano D, Yefet Y, Seidman DS, Goldenberg M, Mashiach S, Oelsner G. Laparoscopy versus laparotomy in the management of adnexal masses during pregnancy. Fertility and Sterility. 1999; 71(5):955-60. [DOI:10.1016/S0015-0282(99)00064-3] [PMID]
[13] Curet MJ, Vogt DA, Schob O, Qualls C, Izquierdo LA, Zucker KA. Ef- fects of CO2Pneumoperitoneum in Pregnant Ewes. Journal of Surgical Research. 1996; 63(1):339-44. [DOI:10.1006/jsre.1996.0272] [PMID]
[14] Rauf A, Suraweera P, De Silva S. Operative laparoscopy; Is it a safe option in pregnancy? Gynecological Surgery. 2009; 6:381-4. [DOI:10.1007/s10397-008-0417-7]
[15] Ye P, Zhao N, Shu J, Shen H, Wang Y, Chen L, et al. Laparoscopy ver- sus open surgery for adnexal masses in pregnancy: A meta-analytic review. Archives of Gynecology and Obstetrics. 2019; 299:625-34. [DOI:10.1007/s00404-018-05039-y] [PMID] [PMCID]
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Issue | Vol 6 No 6 (2021): November-December | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/crcp.v6i6.9166 | |
Keywords | ||
Adnexal torsion Ovarian cyst Pregnancy Laparoscopy |
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