Intestinal obstruction as a presentation of a huge ovarian cyst

Abstract

An ovarian cyst is a fluid-filled sac in an ovary,
surrounded by a very thin wall, located within the ovary
(Reding D et al., 2008). The study of Mohan H et al. in
2006 reveals that it can develop from the neonatal period
to post menopause. They occur most often, however,
during a woman's childbearing years (Wani S et al., 2002
and Moslemi K et al., 2010). Asymptomatic ovarian mass
is a diagnostic challenge for any gynecologist or surgeon.
Accurate clinical assessment and expert radiological
diagnosis can provide a better management protocol. A
42-year-old Indian married and multiparous woman
presented in outpatient door with a history of gradually
increasing abdominal swelling since 5-6 months with
constipation. There was no history of colicky pain, fainting
attacks, vomiting or other gastrointestinal attacks. She
had no previous history of any illnesses, allergies or
operations. She gave history of normal regular menses.
On general examination, Pallor was present and vital
signs were normal. There was no icterus, edema, or
lymphydenopathy. On clinical examination, lump was
freely mobile with cystic consistency and non tender.
Percussion note was dull all over the abdomen.
Abdominal bowel sounds were heard normally. The
abdominal skin was tensed but non-tender. She was
admitted into the female surgery ward. Routine blood and
urine investigations were within normal limit. Chest and
abdominal roentgenogram was normal. Ultrasonography
of the abdomen and pelvis revealed massive
intraperitoneal mass with cystic collection completely
filling the peritoneal cavity. Radiological diagnosis
confirmed on abdominal computer tomography. After an
extensive workup, diagnostic dilemma was there