WANDERING OVARYWANDERING OVARY

DR. 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

UltrasonagrUltrasonagram 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 out

LEFT 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

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