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2022-RA-1199-ESGO 5 times ovarian pedicle torsion due to pedunculated paratubal cyst in 15 years old girl
  1. Huda Abdelrhman Osman Ahmed1 and
  2. Sameer Abdelraheem Sendy2
  1. 1Obstetrics and gynecology, Sulaiman Alhabib Medical Group, Riyadh, Saudi Arabia
  2. 2Obstetrics and Gynecology, Sulaiman Alhabib hospital, Riyadh, Saudi Arabia


Introduction/Background Paratubal cysts may mimic ovarian cysts, and most of them are diagnosed postoperatively. They originate from the mesosalpinx between the ovary and the fallopian tube. Only a few are large, and most paratubal cysts are less than 10 cm. We report a paratubal cyst in a 15-year-old woman, whose only preoperative complaint was abdominal pain and vomiting. Conservative surgery was performed with cyst removal while preserving the ovaries and tubes and detorsion. A paratubal cyst should be included in the differential diagnosis of a large pelvic masses, especially in the reproductive age group

Methodology The patient was 15 years old single lady presented with sudden severe left lower abdominal pain which radiated to the groin and associated with vomiting and mild fever she was single medically and surgically free menarche at 11 years old with regular cycle LMP was one week ago. On Examination she was in severe lower left-abdominal tenderness and rebounding ultrasound showed left adnexal cystic structure with multiple septation suggesting hemorrhagic cyst 4.9x5.6 cm ? Signss of ovarian torsion, CT pelvis showed the cyst and confirmed ovarian torsion.

Results Urgen laparoscopic surgery was done and we found the left ovarian pedicle torted 5 times with a pedicle of paratubal cyst which was making 5 loops around the ovarian pedicle and torted together. Detorsion done and the paratubal cyst was removed with its pedicle and signs of revascularization was observed in the left ovary histopathology result showed cyst excision benign cystic structure with ciliated epithelium and fibromuscular wall-consist with dilated fallopian tube segmen.

Abstract 2022-RA-1199-ESGO Figure 1
Abstract 2022-RA-1199-ESGO Figure 2

Conclusion This case suggests that a paratubal cyst should be included in the differential diagnosis of pelvic masses, especially in the reproductive age. A paratubal cyst may mimic an ovarian cyst preoperative.

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