Acute abdomen in pregnancy, not to forget twisted ovarian cyst: a case report
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232312Keywords:
Acute abdomen in pregnancy, Ovarian torsionAbstract
Aim of the study was to present a case of acute abdomen in pregnancy with twisted ovarian cyst which is a rare entity. A primigravida with period of gestation 25 weeks presented to casualty with acute abdomen. Her USG Doppler revealed findings of ovarian mass of around 9 by 6 cm which underwent torsion. Patient was taken up for emergency laparatomy. Per operatively right sided tubo-ovarian mass-9×8×5 cm, dumbell shaped, fleshy, hemorrhagic and necrosed with one twist over the pedicle seen separate from the uterus. Left side tubes and ovaries seen normal, uterus-26-week size. Frozen section revealed benign pathology. Postoperatively patient was done well and delivered a healthy baby at term via cesarean section. High index of suspicion, regular antenatal follow up and analysis of related risk factors, early and prompt diagnosis and timely intervention in cases of ovarian torsion in pregnancy can change feto-maternal outcome. Meticulous planning and timely intervention under multidisciplinary care team at a tertiary care centre reduces feto-maternal morbidity and mortality.
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